
Class. 
Book. 









Copyright^ . 



COPYRIGHT DEPOSOi 



BETTER BABIES 

DESIGNED FOR 
PHYSICIANS, NURSES AND MOTHERS 



TABLE OF CONTENTS 

Foreword. 

Better Fathers — Better Mothers — Better Babies • • 7 

Protecting the Mother to Preserve the Child ... 9 

How to Help the Mother's Supply of Milk .... 11 

No Satisfactory Substitute for Mother's Milk ... 13 

High Nervous Tension of Pregnant Women .... 16 

On What Does Lactation Depend? 18 

Chemical Examination of the Milk Necessary ... 19 

Long and Tedious Labor Affects the Milk Supply . 20 

A Good Obstetrical Nurse Necessary 21 

The Care of the Breasts Important 23 

Preventing the Bottle-Fed Baby 26 

Only Perfect Mothers Can Bear Perfect Children . 27 

Pre-natal Precautions 28 

Signs and Symptoms of Pregnancy 31 

Diet for the Pregnant Woman 32 

Exercise for Pregnant Women 34 

Clothing During Pregnancy 36 

Bathing During Pregnancy 37 

Sexual Intercourse 37 

Preparation of Room for Confinement . 38 

Choosing a Room for Confinement 38 

Keeping the Baby in an Adjoining Room 40 

Hurry to be Avoided 41 

Preparation of the Bed Before Confinement .... 42 

Tying the Cord Very Important 42 

Preparations for the Child Itself 43 

New Navel Band and the Better Way of Putting a 

Diaper on a Baby 45 

The Adjustment of the Diaper 49 

Conditions Produced by the Old Method 55 

Development 58 

Do Not Frighten Baby 61 

Care of the Eyes at Birth 62 

Registered Physicians ONLY Should Attend Such 

Cases 63 



LIST OF ILLUSTRATIONS 

Opposite 
Page * 
Dedication — Frontispiece. 
The Old Way of Putting on the Navel Band ... 46 

The New Navel Band 47 

X-Ray of Infant Pelvis at Birth 49 " 

X-Ray of Infant Pelvis with Diaper and Pin ... 50 

Interior View of Infant Pelvis at Birth 51 

Old Method of Putting on Diaper; Very Loose • • 52 ' 
Old Method of Putting on Diaper a Little Tighter . 53 -» 

New Method of Folding Diaper 54 

Adjusting New Method 55 

Front View of New Way Completed 56 

Rear View of New Way 57 s 

Correct Way to Take Rectal Temperature in Bed • 162 • 
Correct Way to Take Rectal Temperature Out of 

Bed 163 

Mirror Tooth Brush Drill 213 

Had I But Known 242 



Better Babies 

A Guide to the Practical Care 
of the Mother and Young Child 



SAMUEL A. VISANSKA, Ph.G., M.D. 

Formerly Professor of Theory and Practice of 

Pharmacy, Southern College of Pharmacy; 

Founder Children's Clinic, Wesley House; 

Physician to Home for Incurables ; 

Former Chairman Milk Committee, 

Atlanta Chamber of Commerce 



ATLANTA, GA. 
FOOTE & DAVIES COMPANY 

1917 



-a* 






E««B.ACCO. M .OTO™.ACTOrCO.O.«. 

[ N the Year 1917 



SAMUEL A. VISANSKA 
:e of the Librarian o 

ALL RIGHTS RESERVED 



IS THE OFFICE OP THE LIBRARIAN OF CONGRESS 



JAN 31 1917 

©CLA453869 

hi l..i~0 >^ 




ANN I S. A. JR. 

TO 

MY CHILDREN, 

WHO HAVE INSPIRED ME TO HELP OTHER CHILDREN, 
THIS BOOK IS 

AFFECTIONATELY DEDICATED 



FOREWORD 

I feel it is due my readers to explain WHY 
I have written "Better Babies/' Of course, 
my basic reason for so doing is my ever-pres- 
ent desire to see a world filled only with "bet- 
ter babies," and toward that end I have worked 
for years, devoting myself almost exclusively 
to the treatment of infants and young children. 
I felt that the medical profession would never 
fully perform any real service for humanity 
until the diseases of children were given the 
universal care, attention, and interest which 
they merit. 

But as the function of a physician is not only 
to cure disease when it occurs, but also to pre- 
vent its appearance whenever possible, I found 
myself, a few years ago, investigating preven- 
tive methods for many diseases of children. 
With this end in view I was, naturally, attracted 
to the dressing of the new-born infant and the 
children of a little older stage — hence my con- 
clusions as to the diaper and the navel band. I 
know that new ideas are not always accepted 
eagerly or kindly, and, therefore, it was with 
some timidity that I first spoke on this subject 
before the South Carolina Medical Association 
in an annual session of that organization. To 
my surprise, my address was published in the 



local press, and at once its salient features be- 
gan to be copied throughout the country by 
lay as well as by medical journals. This re- 
sulted in an avalanche of letters coming to me 
from all parts of the country, asking for fuller 
descriptions of my "better way of putting on a 
diaper," and of my "new navel band idea." 
These letters I answered as conscientiously as 
I could, but this book is written as a fuller re- 
sponse to my absent and unknown correspond- 
ents. 

Again, I was called upon to address different 
associations of women who were devoting them- 
selves to the promotion of child welfare 
throughout the country, and the cordial recep- 
tion given to my talks about the diaper and 
navel band, and the insistent requests which 
were made for photographs, reasons, etc., 
formed another link in the chain of circum- 
stances which seemed drawing me closer and 
closer to the incident of writing a book. 

While I fully realize that many points in this 
book have been covered before by the innumera- 
ble books already on the market, and which 
deal with this same subject of the infant and 
young child, still it has been my endeavor to 
cull, from all of the authorities within my reach, 
the best and most pertinent facts, which, cou- 
pled with my own wide experience in the care 
of children, may prove useful to my readers 



to-day and may also have some influence on the 
possible readers of the future, which even the 
humblest writer always hopes to secure. 

I have given credit to the different authors, 
physicians, and other authorities quoted within 
the following pages, but I wish especially to 
thank here Dr. R. L. Hannah for his assistance 
with the photographs, taken post mortem, to 
illustrate the diaper article, and Dr. John Derr, 
both of Atlanta, who made the excellent X-Ray 
photographs, as well as Mr. Alf Lomax, the 
well-known Atlanta photographer, who pro- 
duced the finished pictures. Miss Crawley, R. 
N., also ably assisted me with the pictures of 
the living infant in illustrations of the diaper, 
and Miss Carroll Swann, R. N., aided in the 
taking of the pictures illustrating the navel band 
and the temperature-taking. 

I commend this, my "first attempt," to the 
kindly and therefore lenient consideration of 
my fellow practitioners, as well as to that of the 
general public who share with me a desire to 
increase and to promote an era of "Better 
Babies." 

1203-4 Fourth National Bank Bldg., 
Atlanta, Georgia. 



BETTER FATHERS— BETTER 

MOTHERS— BETTER BABIES 

One of the most helpful indications of our 
present day life is the growing spread of 
scientific and intelligent attention which we are 
giving to our babies. In fact this attention may 
be deemed the very cornerstone of our civiliza- 
tion, for it is universally admitted that in build- 
ing a firm structure of child welfare we have 
laid the foundation for race welfare. 

Communities in many parts of the world 
have taken careful note of the health of the 
children and it has been truly said that "infant 
mortality is the sensitive index of the social 
progress of a people." 

In a small community in France the mayor 
of the commune was a physician and a philan- 
thropist; the infant mortality in that commun- 
ity for a period of ten years was zero; that is 
to say, every child born in ten years was alive 
and well at the end of that time. This indi- 
cates what authority, knowledge and energy, 
if united even in a single man, can do. 

In New Zealand more than 25,000 children 
are born every year and in one city, Dunedin, 
there is a population of some 70,000 and here 
the infant mortality is but 3.8 out of every hun- 
dred, due to the intelligent organization of the 



BETTER BABIES 7 

people into a Society for the Health of Women 
and Children which maintains district nurses, 
and encourages education among the people on 
subjects of health, sanitation, diet, etc. 

In our own country we need more interest in 
the health of our children, although within the 
past decade much progress has been made along 
this line. The National Congress of Mothers 
with its educational leaflets, the splendid work 
done by the Woman's Home Companion Maga- 
zine in its instructive articles regarding the care 
of the mother and young child and with its sys- 
tem of Better Babies Contests and the indi- 
vidual efforts of nurses, physicians and mothers 
to learn, to educate and to guide all combine 
to promise a marked decrease in infant mortal- 
ity in our own country. In order to contribute 
in some small measure to this much-needed end, 
this book is written, and because I feel that bet- 
ter babies must result first from better fathers, 
and better mothers, I devote this first chapter 
to a consideration of the health of the parents, 
for, as Dr. Oliver Wendell Holmes has said, 
the secret of longevity is "to advertise for long- 
lived parents before we are born." In this is 
foreshadowed the scientific sunshine of the pres- 
ent when we, ourselves, are creating the long- 
lived parents of the future by protecting and 
preserving the infants in our care to-day, for, 



8 BETTER BABIES 

before we are aware, the present becomes the 
future, and the great eternal cycle upon which 
the race is founded has begun. 

Child study, both from a physical and a 
moral point of view is really a science and one 
which mothers and fathers, too, will do well 
to master. Highly important as is the physical 
well being of a child, the parent's duty is not 
performed when a child is kept physically per- 
fect, for the moral development of our off- 
spring is equally important. While I shall not 
attempt to give any description of the psychol- 
ogy of the child, still I must urge that both pa- 
rents should consider themselves equally respon- 
sible for every phase of the child's development, 
the responsibility resting upon the father equally 
as upon the mother, although the latter too 
often assumes it all. No child should be left 
solely to the care of a hired nurse; the nurse 
is the assistant, not the substitute, of the parent. 
From its earliest years every child should be 
made the companion of both parents and should 
be led by maturer intellects into pathways suit- 
able for the plastic young minds. It often galls 
me beyond expression to see a careless mother 
or an indifferent father. Some fathers of my 
acquaintance seldom see or speak to their chil- 
dren, feeling, apparently, that when its mate- 
rial needs are provided for he has done his 



BETTER BABIES 9 

duty. But the bestowing of life is a doubtful 
blessing and even at best it demands safeguards 
and protection. As a father myself, and as a 
physician as well, I feel these facts most keenly 
and am anxious to do my part toward contribut- 
ing to the welfare of the world by presenting 
here some pertinent facts as to the preservation 
and improvement of the child. 

Protecting the Mother to Preserve the 
Child. 

One of the secrets of successful medical prac- 
tice to-day is found in preventive measures. I 
deem it of the utmost importance that the health 
of the unborn child be given some measure of 
preservation by protecting the mother who is 
to bring it into the world. The modern science 
of Eugenics has for its keynote this salient fea- 
ture and despite the many errors which have 
gathered around the mere word, the theory be- 
hind it is sound. Chief among the safeguards 
which we can prepare for the unborn child is 
that of providing for it a supply of nourish- 
ment such as Nature, Herself the Universal 
Mother, intended. No mother can afford to 
ignore the fact that it is her absolute duty to 
nourish her child herself. No physician can 
dare ignore his responsibility in aiding the 
mother to prepare this nourishment before the 



IO BETTER BABIES 

new life comes into the world. I believe this 
can be done and I hope the day is not far dis- 
tant when my fellow practitioners all over the 
world will agree with me in this belief. 

It is a fact that of all barbarous customs, 
of all uncivilized methods which our over-civi- 
lized modern life permits, that of the bottle-fed 
baby is perhaps the most barbarous and the 
most uncivilized. In fact the only parallel to 
this which we can find in ancient history is, per- 
haps, the infant sacrifices to the god Moloch, 
who demanded fresh child's flesh as his daily 
diet ! 

If our own government ever would become 
really and helpfully paternalistic, it seems to 
me that it might well begin with systematic pre- 
vention of the bottle-fed baby. And it is, in- 
deed, a good indication of the attitude of the 
government to this very question that the De- 
partment of Child-Helping of the Russell Sage 
Foundation, which is under the direction of the 
Children's Bureau, gives special attention to 
the care of the baby, and its proper nourish- 
ment. 

I think all true physicians should give this 
important subject careful thought, for to them 
is entrusted the duty of impressing the expect- 
ant mother with the weight of her sacred ob- 
ligation to the unborn child. 



BETTER BABIES II 

The mother herself often does not recognize 
the danger to her child in artificial feeding. 
She hears of all the "fine foods on the market" 
and she hears, too, of the loss of time and of 
the discomfort to herself, or as I once heard 
a young mother say, of the "slavery" to her- 
self if she nurses her baby. Hearing and think- 
ing thus she tries the advertised foods, and in 
an incredibly short time the healthily born baby 
is a little wasted wreck, with all its natural phys- 
ical powers blighted, and, if life itself be 
granted to it, its whole future is clouded by the 
shadows of that first fight against actual starva- 
tion. 

How to Help the Mother's Supply of 

Milk. 

Of course this does not apply in the most 
remote way to those unfortunate young mothers 
who would gladly nurse their babies but who, 
for some physical reason, seem unable to do so. 
Naturally we physicians are asking ourselves 
if there is not some tenable way to overcome 
such conditions. I have been carefully investi- 
gating these conditions and I believe that help 
can be given in many cases. 

To begin with, the prospective mother should 
carefully consider her own health from the first 
moment that she recognizes her condition. This 



12 BETTER BABIES 

does not mean that she should become a morbid 
recluse, for there is the social side of the ques- 
tion to be considered. But no physician wishes 
to consign the prospective mother to social se- 
clusion during the early months of pregnancy 
nor during those months when she is nursing 
her baby, nor would the physician advise the 
mother to neglect her simple social duties and 
pleasures during this time. On the contrary, 
rational and reasonable social pleasures are to 
be desired, but these should be taken in modera- 
tion and with a due regard to the grave respon- 
sibilities which the future will bring forth. 

On the other hand, it is an undeniable fact 
that undue social excitement; too much expos- 
ure of the neck and chest, such as the modern 
evening gown dictates; too much taxing of the 
nerves, the digestion, or the brain; all combine 
to prevent the highest physical efficiency in the 
prospective as well as in the nursing mother. 
In this connection there is a principle of Eu- 
genics involved and young men desiring normal 
offspring should consider well their choice of a 
wife and should, if possible, select such life part- 
ners as seem to be sensible enough and unself- 
ish enough to willingly consider the welfare of 
those other lives which may emanate from their 
own. 



BETTER BABIES I 3 

No Satisfactory Substitute for Moth- 
er's Milk. 

Naturally the young mother will hear of 
myriad substitutes for Nature's nourishment, 
but I shall broadly assert that there is not a sin- 
gle one of them which will permit an infant to 
begin life with the same physical equipment as 
that which flows from the normal breast of a 
normal mother. On the contrary, chemical 
analysis has shown that most of the baby foods 
now on the market are actually deficient in those 
qualities which support life and these so-called 
"substitutes" really produce scurvy and rickets 
in young children. Again, no two babies are 
ever exactly alike in digestive and assimilative 
functions, any more than they are in form and 
feature, and each infant is a law unto itself. 
For this reason I shall give no milk formulas 
in this volume and shall not even suggest suit- 
able foods for infants. The subject is too seri- 
ous for experiment and too important for con- 
jecture. 

Statistics have proven that over 20 per cent, 
of all the children born into the world die from 
improper feeding, which causes a long train of 
gastro-intestinal diseases. I have proved this 
many times in my own personal experience, and 
I can not urge too strongly the need of enlist- 



14 BETTER BABIES 

ing all classes and all persons, interested in the 
welfare of humanity, to unite with the physi- 
cians and guardians of the public health to pre- 
vent the bottle fed baby. 

Here, indeed, is a cause which ministers, doc- 
tors, nurses, and women's clubs throughout the 
country might well advocate. Lectures on the 
subject should be given whenever possible and 
the omnipresent and impressive picture shows 
should display regular screens on this subject. 
The nation-wide movement for a "Baby Week" 
throughout the country would do well to devote 
one day to the sole subject of baby's food and 
this should mean MOTHER'S MILK. 

As a Southern physician I have observed that 
most negroes have a very ample milk supply; 
this would seem to prove the theory that a 
sunny, cheerful temperament, a simple and 
wholesome life, all combine to create ideal con- 
ditions for milk producing. During the old 
slavery days, when negroes were guarded care- 
fully by their owners because of their actual 
financial and physical values, almost every 
mother was able to nourish at least two babies 
at the same time, so freely did she produce milk, 
and good milk, too. To-day, almost without 
exception, the negro woman nurses her own 
child, and she rightly values this splendid food 
supply, allowing no conditions to prevent her 



BETTER BABIES 1 5 

use of it. This was strikingly illustrated in a 
Southern city on one occasion when a motherly 
looking colored woman got on a street car hold- 
ing a young baby in her arms. Apparently it 
was "feeding time" and environment did not 
serve to deter this mother from administering 
the nourishment when it was due, so she began 
at once to give the baby the breast. The child, 
however, diverted by the unusual surroundings, 
refused to nurse, when the mother, completely 
oblivious of her surroundings, was heard to re- 
mark emphatically: "Look 'er har, you Teddy 
Roosevelt, you better take yer dinner; you bet- 
ter had, fer ef you don't, I shore is gwine to 
give it ter der conductor." The general laugh 
of the passengers which followed this declara- 
tion was apparently unnoticed by the mother 
and finally the sturdy infant "Teddy Roose- 
velt" was induced to proceed with the delayed 
"dinner." 

While I do not advocate quite this lack of 
social convention in the administration of nour- 
ishment, I do use this incident as an object les- 
son to more socially conservative mothers, and 
would urge that nothing be permitted to inter- 
fere with the child's regular hours for food. 

Then, too, I would urge that all physicians 
carefully consider the strong necessity of en- 
couraging lacteal health as one of the main con- 



I 6 BETTER BABIES 

siderations in the care of the prospective mother. 
I am sure this is often overlooked and I realize, 
too, that for many reasons it is a delicate sub- 
ject, as Nature often fails to supply modern 
mothers with the adequate quantity and quality 
of milk. Each case, therefore, which comes to 
the physician's notice, should be given careful 
and individual attention, both to prevent the 
trouble from occurring in the first instance and 
to relieve it when it does occur, despite our best 
efforts. 

High Nervous Tension of Pregnant 
Women. 

First we must remember that in the preg- 
nant woman every organ is under high tension, 
and that any discord, either physical or mental, 
is liable to play havoc with the milk secretions. 

Most women do select a good physician soon 
after they are aware that conception has taken 
place, and those who fail to do this should be 
urged to do it at once. The first duty of this 
physician should be to so instruct the patient as 
to give her every chance of an easy labor and 
also to encourage the milk secretions. An im- 
portant feature of this situation is that the preg- 
nant woman should be given this care during 
the FIRST MONTHS of pregnancy and not, 
as so often happens, during the last months. 



BETTER BABIES I 7 

The pregnant woman must know that she needs 
the most careful examination from her physi- 
cian, with special attention directed to her blood, 
heart, kidneys, and nervous system. 

I lay special stress on the blood examination 
at this stage, for the reason that a great many 
women are anaemic, and I consider anaemia 
one of the principal aetiological factors in pre- 
venting the normal milk secretions, thus 
eventually necessitating the bottle-fed baby. 
While it is true that the pregnant woman takes 
on flesh it must be remembered that this is some- 
times at the expense of the blood supply to the 
foetus. Even the blood of the so-called fat 
woman is often found deficient in haemoglobin, 
and while such women might even have large 
bulging breasts, they usually show a deficient 
milk supply. 

It is at this point that the struggle to induce 
a normal milk supply should begin and Nature 
should be aided in producing a normal infant. 
With a carefully reared foundation of proper 
hygiene, suitable food, the requisite amount of 
exercise and rest, together with, perhaps, a tonic 
containing iron, we can avoid, in almost every 
instance, what I have termed the "stuffing proc- 
ess" which is so often practiced to produce or 
induce milk after the child is born. So often 
when the milk supply of a newly made mother is 



I 8 BETTER BABIES 

found lacking in quantity and quality, the usual 
routine is to order teas, meats, milk, broth, 
cocoa, potatoes, etc., the idea being for the 
mother to "take all she can hold." It is not 
reasonable to expect Nature to accomplish in 
a few days what it would really require weeks 
to bring about. Grant, on the other hand, that 
the milk comes to the mother normally on the 
third day and for a few weeks she is able to 
produce enough for her baby's needs. In more 
cases than we like to recall this supply does 
not continue, and the problem then becomes 
grave, for often the very life of the baby de- 
pends upon the physician's skill in inducing the 
milk supply. 

On What Does Lactation Depend? 

The failure to accomplish this is at last bring- 
ing the whole subject to the attention of scien- 
tists, and experiments are constantly being made 
to determine on what lactation really depends. 
Theories have been advanced by many scien- 
tists on this subject and within the not far dis- 
tant past Miss Lane Claypon, Prof. Starling and 
O. H. Scott of Philadelphia have all advanced 
certain theories as to the growth of the mam- 
mary glands during pregnancy and also as to 
what will affect the secretions of the glands. 
Mackenzie, also, has declared that Pituitary ex- 



BETTER BABIES I 9 

tract is most active in promoting these secretions. 
While all of these experiments and conclusions 
are of profound interest, I do not think any of 
them have been extensive enough to prove con- 
clusively that there is not a nervous element 
largely responsible for a deficient milk supply. 
In fact, I am sure that in many cases a strong 
psychological force can be brought to bear on 
the mother, which is entirely independent of any 
physiological conditions. Cases where the 
milk supply is deficient need all possible en- 
couragement from the physician and nurse, and 
while making persistent efforts to discover why 
the mother's milk supply is deficient the physi- 
cian should never fail to give, at the same time, 
every possible mental suggestion which he can 
conjure up in order to induce the mother to be- 
lieve that she will certainly be able to nurse her 
child rather than, as often happens, deciding 
that this will not be possible, and, with one or 
two futile and feeble attempts to increase the 
milk supply end in ordering some one of the 
artificial foods on the market. 

Chemical Examination of the Milk 
Necessary. 

A thorough examination should be made of 
the mother and of the milk itself in order to 
ascertain if it is deficient in fats and proteids, 



20 BETTER BABIES 

and if this is found to be true, then the proper 
diet and exercise should be ordered to improve 
this condition. Sometimes it may be necessary 
to relieve the mother a little by placing the baby 
on a bottle or two a day, during which time the 
mother should be given careful treatment, her 
surroundings should be kept as hygienic and 
pleasant as possible, and these methods, coupled 
with a judicious iron tonic, will often result in 
inducing the milk back to a normal flow. I have 
found that Nutrolactis will often prove helpful 
in cases of this kind while sometimes a change 
of air and scene for the mother will do more 
good than all the medicinal tonics. 

I would stress again the value of constant 
encouragement from the physician, for the 
patient sub-consciously relies on the verdict of 
her doctor and to be assured that "her milk will 
certainly come freely" often results in bringing 
about this very condition through the action of 
the sympathetic nervous system. 

Long and Tedious Labor Affects the 
Milk Supply. 

One factor causing a deficient milk supply is 
not usually given sufficient consideration, and 
this is the permitting of a patient to undergo 
too long and too tedious a labor which could be 
safely shortened by the instrumental delivery. 



BETTER BABIES 21 

Again a too liberal use of an anesthetic during 
labor might tend to delay the milk flow, and the 
exact amount of the anesthetic should be care- 
fully studied with this end in view. 

Skillful care and attention should be given, 
of course, to post partum hemorrhage, lacera- 
tions should be promptly and skillfully repaired 
in order to prevent undue tax on the patient's 
system, and every possible feature of the labor 
which might tend to tax the patient's nervous 
system should be avoided if for no other reason 
than because of its undoubted influence on the 
milk supply. 

A Good Obstetrical Nurse Necessary. 

Yet another feature which, in my experience, 
has proven to be a factor in assuring strong, 
healthy, normal children, is the engaging by the 
prospective mother of a thoroughly competent 
obstetrical nurse. It is a deplorable fact that 
the majority of nurses lack this special training 
or perhaps avoid it because of its exacting de- 
mands. But it is obviously true that the average 
busy physician can not possibly give the neces- 
sary time and attention which every obstetrical 
case demands, which is merely another argument 
in favor of the nurse's being almost a medical 
assistant in such cases. This is especially true 
where Nature requires outside assistance, and 



22 BETTER BABIES 

while it has been said that there are physicians 
who leave too much to the nurse, it might also 
be said that the majority of nurses have no 
adequate conception of the gravity of their re- 
sponsibilities in obstetrical work. Every nurse 
undertaking such work should have absolute 
knowledge of the proper method of handling 
troubles that constantly arise, and which can not 
possibly be foreseen or avoided but which must 
be met promptly and intelligently, even before 
the attendant physician can be communicated 
with. 

A nurse should understand thoroughly every- 
thing connected with the care of the breasts, for 
often delay in applying the indicated remedies 
at the proper time may result in losing the milk 
secretions altogether. 

Then, too, it is wrong to assume that because 
a mother nursed her first baby she will be able to 
do the same thing with her second and vice 
versa, and for this reason a nurse should keep a 
careful record of every case she handles and a 
mother, also, should be able to tell the nurse and 
the physician of any past difficulties she may 
have had, in order to prevent a recurrence, if 
possible. 

I think many medical colleges fail to give 
sufficient training to students in medicine as to 
the care of the woman before and during preg- 



BETTER BABIES 23 

nancy, and training schools for nurses are often 
lacking in the same way. Such training should 
cover a thorough understanding of the physi- 
ology and anatomy of the mammary glands, as 
well as of the entire body, and every physician 
should be able to make a scientific examination 
of the mother's milk, in order that he may detect 
wherein it is lacking, and once having deter- 
mined this, he should be able to correct the con- 
dition by directing proper diet, and he should 
insist that his directions be carefully carried out 
by the patient. 

The Care of the Breasts Important. 

I believe that we should give more attention 
to the care of the breasts themselves, both be- 
fore and after the birth of the child. Oni, an 
authority on this subject, said, when treating the 
question of sore nipples, that one out of every 
two women suffered from this ill. The physi- 
cian, therefore, should carefully examine the 
nipples and if they are found to be small, flat, 
and lacking in sufficient protruberance, they 
should be given gentle manipulation. Pulling 
the nipples outward should be regularly prac- 
ticed, and a lotion, not too astringent, should be 
applied. If this should fail to produce the 
proper development of the nipples, then a breast 
pump should be used, and I have found the Yale 



24 BETTER BABIES 

pump the best. It works on the same principle 
as a bicycle pump and it certainly does succeed 
in elongating the nipples. If the breasts of the 
patient are carefully examined, it will be seen 
that near the base of the nipples and upon the 
surface of the alveoli there are numerous seba- 
ceous glands which become enlarged during lac- 
tation and present the appearance of small 
tubercles beneath the skin. These glands seem 
to secrete a peculiar fatty substance which serves 
as a sort of protection to the integument of the 
nipple during the act of sucking, and when this 
is absent, there occurs what might be called "dry 
sucking," and the nipples often become macer- 
ated, while fissures occur and bacteria gain en- 
trance to the deeper tissues, causing mastitis and 
sometimes suppuration. Should mastitis or 
caking occur a harmless oily substance (Olive 
oil or cocoa butter) may be applied by a gentle 
but thorough massage and after nursing an as- 
tringent solution of some good antiseptic should 
be used on the breasts. 

Care should be taken, however, to carefully 
wash the breasts before each nursing if any 
preparation has been used. Use sterile water, 
warm, for this purpose and a sterile piece of 
gauze. 

If fissures do occur I have found the follow- 
ing very useful : 



BETTER BABIES 2$ 

Alum, i drachm. 

Glycerite of Tannic Acid, 4 drachms. 

Antiseptic solution, (U. S. P.) 3 ounces. 

Lime water to make 1 pint. 

After the last nursing of the day, when the 
breasts rest for several hours at least, it is well 
to apply an ointment consisting of 

Balsam Peru, 1 drachm. 

Lanolin. 

Coldcream of each, 4 drachms. 

To prevent sore nipples the astringent solu- 
tion should be used once daily before the birth 
of the child and after the birth each nursing 
should be followed by an application of the 
same solution. 

Should mastitis occur, and pus be formed, sur- 
gical treatment should be given without delay. 

Both nurse and physician should have a 
thorough knowledge of breast massage and also 
a knowledge of when it is to be used, as this is 
perhaps the one sure way to relieve what is 
known as "caking of the breasts," which is not 
only one of the most painful of ills connected 
with breast feeding but which also leads to most 
serious complications. Breast massage should 
be given very carefully and gently, and I have 
also found that a mild Faradic current of elec- 
tricity is helpful in curing breast troubles and 
also in encouraging the lacteal flow. 



26 better babies 

Preventing the Bottle-Fed Baby. 

From what I have said here it is evident that 
to prevent that great factor in infant mortality, 
the "bottle-fed baby," we must combat condi- 
tions which precede the life of the infant on 
earth, and that our care and attention should 
really begin with the first dawn of that life, from 
the moment it is generated. Indeed, I can not 
too strongly impress my readers with the fact 
that in my own opinion and in the opinion and 
experience of other physicians as well, the bottle- 
fed baby is the BADLY-FED baby, and we all 
know that this means the weak, the emaciated, 
and the unnatural and sub-normal baby. 

For this reason I would urge not only physi- 
cians, but mothers and nurses also, to unite in a 
campaign of education which shall first teach the 
vital need of natural nourishment for our in- 
fants; and when this need is clearly recognized, 
then we should all unite in creating that physical 
fitness of the mother which shall enable her to 
give this natural nourishment and keep its sup- 
ply unstinted, during the months when it is a 
prime factor in her child's health as well as in 
its future fitness to do battle with the world. 

We can do much to bring about this end by 
diplomatic means; we can, in myriad instances, 
give instruction, encouragement, and assistance, 
and I believe that the majority of our American 



BETTER BABIES 27 

women will only require to be told of the 
dangers threatening the bottle-fed baby to in- 
spire them to co-operate with physicians and 
nurses in a concerted effort to prevent the con- 
tinuance and increase of what can only be term- 
ed a social menace. 

Only Perfect Mothers Can Bear Perfect 
Children. 

Few human beings are "perfect" from a 
physiological viewpoint; this, physicians recog- 
nize clearly, but it is also true that there are 
even fewer human beings who can not be made 
physically better by intelligent care and con- 
servative precautions. This is more positively 
true of the prospective mother than of any other 
individual. In fact, the practical care of the 
mother begins long before the baby comes into 
the world, and I have always deemed a woman 
a mother from the time she becomes impreg- 
nated. Of course, we all deplore any woman 
becoming pregnant who is afflicted with syphilis, 
tuberculosis, epilepsy, cancer, chronic heart or 
kidney lesions, but we all know that such women 
do become mothers and we simply can not pre- 
vent it in the present state of our social con- 
ditions. Such cases we must, from the very 
nature of things, ignore in a work of this kind, 



28 BETTER BABIES 

hence we will take for granted that the average 
woman is healthy, and will advise her from that 
standpoint. 

We have already spoken of the pre-natal care 
necessary to insure the proper nourisment for 
the child, and as every woman desires to bring 
a normal baby into the world, she must con- 
sider her own needs during the months of preg- 
nancy. 

Pre-Natal Precautions. 

While I shall not discuss here the question of 
pre-natal impressions on the child's tempera- 
ment or mentality, or even on its physical char- 
acteristics, because the question is one that has 
never been absolutely determined, still I would 
strongly urge that every prospective mother sur- 
round herself as far as possible with cheerful 
environments and agreeable and pleasant com- 
panions. As the pregnancy advances, the 
woman finds her whole system under a high ten- 
sion, and this is particularly true of her nervous 
system; and when we remember that the nerves 
control the body, it will readily be seen that, in 
like manner, the functions of the body are in- 
fluenced by the nerves. 

If the prospective mother happens to be of a 
highly nervous temperament, easily upset and 
influenced by small discomforts, then she should 



BETTER BABIES 29 

at once consult the best physician in her neigh- 
borhood, who will advise her as to the best 
possible regimen for her during her nine months 
of trial. While a good, equable temperament 
is partly a blessed inheritance, it must be re- 
membered that it is also two-thirds the result 
of personal cultivation, and judicious cultiva- 
tion of your own nerve forces has much to do 
with the future of your offspring. When the 
nerves lose control of the body, little by little 
the body gains control of the nervous system, 
and this results in a typical case of neurasthenia. 
In such cases the mind is not normal, the ap- 
petite disappears, constipation and sluggish cir- 
culation ensue, with defective nutrition for the 
mother a consequent condition for the unborn 
child. In addition to this, the mother's power 
to nurse her baby for the nine or twelve months, 
now deemed necessary, is endangered, and when 
it is considered that a mother must nourish her 
child for at least eighteen months, nine in utero 
and nine after birth, too much care can not be 
given to her own physical condition. Physi- 
cians and nurses should take this into careful 
consideration when caring for a prospective 
mother and she should be given every possible 
advice and attention. 

While I always urge prospective and nursing 
mothers to take a liberal amount of exercise in 



30 BETTER BABIES 

the open air each day, I also caution them 
against undue fatigue. 

The dangers of over-fatigue for the pros- 
pective mother are very real, and every woman 
who finds it necessary to work for a livelihood 
during the months of pregnancy should bear in 
mind the fact that work is harmful only when 
it exhausts the mother, and that when this 
does occur, the foetus of the child is exhausted 
as well, and miscarriage may result. 

Every prospective mother should retire early 
at night, and, especially during the latter part 
of her pregnancy, she should provide herself 
with a light lunch to be eaten during the night 
if she is wakeful. 

I would advise all pregnant women to inform 
their relatives and close friends of their condi- 
tion as early as possible, if for no other reason 
than to enable them to keep from the pregnant 
woman such untoward news as might give her a 
severe shock and possibly produce an abortion. 
If, as sometimes happen, such news MUST be 
conveyed to the pregnant woman it should be 
done as carefully as possible, while preparations 
might be made to meet any possible contingency 
or emergency. I can not urge these precautions 
too strongly, for a pregnant woman is not alto- 
gether in complete control of her own emotions, 
and a shock which she might resist or bear 



BETTER BABIES 3 I 

bravely under normal physical conditions might, 
during her pregnancy, prove of great danger 
to herself and her child. 

Signs and Symptoms of Pregnancy. 

We have pre-supposed that women all know- 
when they are pregnant, or very soon after they 
become so, but, as a matter of fact, cases occur 
not infrequently when it is difficult for even the 
skilled physician to diagnose pregnancy. Of 
course we all know that there are some 
symptoms which usually present themselves, and 
which we have almost grown to consider in- 
fallible. For instance, when a woman who has 
been normal or nearly so in her menstrual func- 
tions misses a period, she should be very sus- 
picious of the cause; and when the suspension 
of the menstrual period is accompanied by 
vomiting and nausea, the probability of preg- 
nancy is much increased. 

Of course there are exceptional cases where 
a woman has menstruated during the full time 
of pregnancy, but this is most unusual. Many 
women never suffer with nausea during preg- 
nancy and are only aware of their condition by 
the cessation of the menstrual flow; in such 
cases it is well to consult a physician after the 
second period, although it is sometimes difficult 
to give a positive diagnosis until about four and 
a half months. 



32 BETTER BABIES 

I have known of cases where women, after 
marriage, are so desirious of offspring that, 
through nervous tension, their abdomen be- 
comes bloated, and they claim to actually "feel 
life" when the fact is that there is merely an 
excess of gas. 

But when the menstrual flow stops, when, 
after a certain length of time, a woman expe- 
riences a tingling sensation and notices also an 
enlargement of her breasts, she may be 
moderately certain that she is pregnant. 

As to the probable time of a woman's de- 
livery, I think it unwise to give here a table of 
such cases, but a physician can determine the 
date with a fair degree of accuracy after con- 
sulting his patient, and this is but another argu- 
ment for securing and consulting a good physi- 
cian as early in pregnancy as possible. 

Diet for the Pregnant Woman. 

It is difficult to outline the exact diet for a 
pregnant woman. Much depends upon the diet 
usually followed, and, as we all know, this varies 
with various people and is influenced largely by 
circumstances, environment, and habit. 

For instance, if a woman is living in the coun- 
try and is accustomed to eating cabbage, turnip 
green, collards, fat bacon, pork, corn bread, and 
cereals, and drinks milk and buttermilk freely, 






BETTER BABIES 33 

I would advise a curtailment of the collards and 
turnip greens and an increase in the amount of 
milk and buttermilk. If, on the other hand, the 
pregnant woman lives in the city, and is accus- 
tomed to eating meat twice or three times daily, 
and eats cream, salads, pastries, and other rich 
food, it would be better for her to indulge in a 
diet of milk, buttermilk, cocoa, cereals, vege- 
tables in season, with very little tea or coffee, 
meat but once daily, fish, oysters, custards, pure 
ice cream, rice pudding, gelatin, fruits that have 
been proven to agree with her, and any other 
easily digested, nourishing food. It would be 
well for her to avoid pastries and heavy salads; 
also wines and spirituous liquors of all kinds, 
unless these are especially ordered by her physi- 
cian for stimulating purposes. It is not prob- 
able that the latter will happen, however, as it 
is more than likely that a judicious tonic will be 
prescribed rather than liquors of any kind. 

All women should recognize this as the most 
critical time of their lives, and they should not 
be guided in the matter of food by the abnormal 
cravings that beset them, nor should they be dis- 
tressed by the nausea or general discomfort 
which they may, and most probably will have, 
but for these and any other symptoms which 
they do not understand they should at once con- 
sult a physician. 



34 better babies 

Exercises for Pregnant Women. 

I have already stated that violent exercise 
leading to fatigue should be avoided during 
pregnancy, but I must stress the acute need of 
daily moderate exercise which contributes 
largely to a woman's comfort during pregnancy, 
as well as to the safety and shortness of her 
delivery. 

I would strongly advise against riding over 
rough roads, dancing, lifting heavy weights, or 
excessive sewing on the machine. The fact that 
"Mrs. X. danced until the seventh month with 
no bad results" does not means that Mrs. Y. can 
do the same thing; on the contrary, in Mrs. X.'s 
case it was "better luck than good management." 
No woman can afford to be guided by what some 
other woman did; she must do what is right for 
herself, and what has been proven to be right 
for the majority will usually result in proving to 
be right for her. The right kind of exercise is 
found in a leisurely walk out of doors, a ride in 
a carriage or an auto over smooth roads and 
not for too great distances, which will give a 
pregnant woman all the fresh air and exercise 
she needs. The walk is particularly recom- 
mended, and should be kept up as long as pos- 
sible, even if taken after nightfall during the 
last few weeks. 



BETTER BABIES 35 

I think women during these trying nine 
months should have pleasant diversion, should 
see an occasional good and cheerful play, an 
entertaining vaudeville or motion picture, a 
quiet game of cards if she enjoys them, but no 
exciting and nerve-racking bridge clubs, or, as I 
have termed them, "chicken salad brigades" 
which tax the digestion as well as the nervous 
system, and no exciting or blood curdling plays 
or pictures. 

Crowded and ill-ventilated rooms, either at a 
theatre or a private party, are to be avoided, 
and no woman can give sufficient time to the 
care of her own health and to her own household 
if she devotes herself to entertainments, eats in- 
digestible food at bridge luncheons and after- 
noon teas, and then, in all probability, misses 
her good, wholesome supper or dinner alto- 
gether. 

As I have said, a pregnant woman needs 
abundance of rest; she should sleep long in a 
well-ventilated room, for sleep is in itself a re- 
storative and nerve builder. I would advise a 
pregnant woman to devote a portion of every 
day, preferably just after the mid-day meal, to 
complete rest and relaxation, an hour's nap at 
this time being most helpful and having a won- 
derfully soothing effect on the nervous system. 



36 better babies 

Clothing During Pregnancy. 

Great care should be taken by the pregnant 
woman as to the sort of clothing she wears. 
This should be so adapted as not to compress 
the abdomen or chest. Of course the quantity 
and quality should be determined by the season 
of the year, but the proper kind of clothing can 
be selected by persons even with the most 
moderate income. Garments hung around the 
waist should be as light in weight as possible, 
and all garments that can possibly be so ar- 
ranged should be suspended from the shoulders. 
Ill-fitting, tight corsets, and tight skirts or gar- 
ments of any kind are actually injurious as they 
impede the expansion of the growing uterus and 
its contents, promoting complications and crea- 
ting symptoms which are not uncommon during 
pregnancy — albuminuria and uremia. For 
women who have borne several children and 
have relaxed abdominal walls, a snug fitting ab- 
dominal bandage gives great comfort, this of 
course to be fitted so as to avoid all possible 
pressure on the pelvis. 

High-heel shoes are especially to be con- 
demned as they are actually injurious because 
they displace the equilibrium of the body and 
consequently of the abdominal organs. 



better babies 37 

Bathing. 

The usual routine in health should be ob- 
served during pregnancy in regard to bathing. 
A daily bath in warm weather and at least three 
times a week in cold weather, should be the rule. 
The baths in cold weather should always be 
taken in a warm room, a full tub bath being 
preferable to a sponge bath. A good drying with 
a rough towel should be had and this followed 
by a gentle but thorough rubbing to insure suffi- 
cient reaction. The water, even in summer, 
should be tepid as a cold bath might prove too 
much of a shock to the foetus. 

As tub baths are more or less fatiguing to a 
pregnant woman they are better taken before 
going to bed or when there is ample time to rest 
immediately thereafter. Judicious bathing is 
really a health-giving practice. 

Sexual Intercourse. 

Very often sexual intercourse has been found 
to be injurious to pregnant women and should, 
therefore, be carefully regulated during the pe- 
riod of pregnancy. In fact much pelvic discom- 
fort has been found to result from this practice 
and it even might cause abortion. During the 
first few months of pregnancy when so many 
abortions do occur and toward the end of the 



38 BETTER BABIES 

pregnancy it is best for husband and wife to 
have separate beds. Many couples do this at 
all times but it is especially to be commended 
when sexual intercourse might be of actual in- 
jury to the wife. 

Preparation of Room for Confinement. 

Having thus considered the care of the 
mother during the months of pregnancy in order 
that she may bring as normal and healthy an 
infant into the world as possible, and also that, 
primarily she may be able to nourish it nor- 
mally when it does arrive, we can now give 
some space to the actual conditions surrounding 
the delivery of the child. As child birth is not 
an emergency nor an accident it is possible to 
make certain preparations for the event which 
can be made available for use in a few moments. 
These preparations are usually the work of 
the mother or nurse. 

Choosing a Room for Confinement. 

The room for a confinement should be chosen 
with care, as much of the comfort of the mother 
depends upon her surroundings after her baby 
is born. I would suggest that, if possible, the 
room to be used should adjoin a bath room, or 
at any rate as near to one as possible, never near 
a sewer. It is of great advantage to such a room 



BETTER BABIES 39 

if it have an open fire place in which a fire can 
be kept burning night and day, if necessary. A 
room heated only by a register is to be avoided, 
as the fire in the furnace often goes out during 
the night and, besides, such a room is deprived 
of the constant ventilation furnished by an open 
fire place. If it could be arranged that the con- 
finement room adjoins a smaller room for use of 
the nurse and child, it will be found most con- 
venient. The furniture in a room to be used for 
a confinement should be very simple, and it 
would be especially convenient to the nurse, as 
well as more comfortable to the patient, if the 
bed could be one of the high, narrow beds used 
in hospitals, or of a similar make. This en- 
ables the linen to be changed more easily and 
also permits the patient to be bathed and cared 
for with greater facility. Window hangings 
and draperies should be dispensed with, and the 
carpet removed from the floor; a small rug is 
really all the floor covering necessary, as this 
can be easily removed, and floor kept free of 
dust, by using a covered broom or an oil mop. 

I would urge that all rooms to be used for 
confinement be thoroughly aired and given as 
much sunshine as possible before the event oc- 
curs, and also that all the wood work be washed 
with a good antiseptic solution and the floor 



40 BETTER BABIES 

also scrubbed with the same. An odorless anti- 
septic is to be preferred for this purpose, and 
there are many such to be had. 

A crib or bed for the child is usually selected 
before the birth; this bed should positively be 
without rockers or swinging motion, and should 
be as plain and simple as possible, in order that 
it may be easily kept clean. A white enamel 
bed with movable sides is to be preferred to any 
other style. 

Keeping the Baby in an Adjoining Room. 

While every young mother naturally desires 
to have her child near her, it is nevertheless 
most undesirable to keep the baby in the same 
room with the mother. Many new born infants 
are restless at night for the first week or ten 
days after birth, and if they are in the same 
room with the mother, she is necessarily dis- 
turbed, and loses her own rest at a time when 
it is most important for her to have it. The 
child should, if possible, be kept in the adjoin- 
ing room with the nurse, thus enabling the 
nurse to care for it during the night without 
disturbing the mother, and yet be near enough 
to the mother to be within call, if needed. The 
nerves of a newly made mother are sensitive, 
and should be guarded most carefully by the 
physician and nurse. For this reason, I do not 



BETTER BABIES 4 I 

think women should have company after child 
birth until the end of the second week or even 
longer. The length of time the mother should 
remain in bed must be determined by the physi- 
cians; there is no hard and fast rule for this 
and many physicians differ as to the proper time 
the organs require to become adjusted. 

I would suggest that every possible precaution 
be taken to preserve absolutely antiseptic con- 
ditions in a confinement room, and especially 
around the mother and child. If the patient is 
unfortunate enough to have an "old granny" or 
midwife in attendance, rather than a regular 
physician, and the very best she can procure, 
then the expectant mother herself should insist 
upon absolute cleanliness on the part of her 
attendant, for much harm is often done by a 
failure to take this precaution. 

Hurry to be Avoided. 

Hurry in a confinement case is to be most 
positively avoided; a physician or midwife can 
scarcely take too much time on such a case and 
Nature will not be hurried. But, as I said be- 
fore, too long and too tedious labors often de- 
mand assistance on the part of the attendant. 

Newly made mothers seldom need much 
medication; often a gentle laxative is about all 



42 BETTER BABIES 

that is required, and I would suggest the follow- 
ing: Castor oil or Fid. extract cascara aro- 
matic. 

Purging is always to be avoided after child 
birth as it weakens the mother when she most 
needs her strength. 

If the patient must be catherized, this should 
be done under the most rigid antisepsis, and, 
in fact, all surroundings should be of the same 
character. 

Preparation of the Bed Before Confine- 
ment. 

Before the patient is put to bed, there should 
be a firm, not too hard, mattress on the bed, and 
over this a rubber sheet should be placed to 
cover the mattress entirely. Over this should 
come a muslin sheet, both being firmly pinned 
down to the mattress. These are then covered 
in turn by another rubber sheet, over which is 
a folded muslin sheet, the latter to be withdrawn 
after the confinement, thus leaving the patient 
with a clean, dry bed formed by the first rub- 
ber sheet and muslin sheet. This will be found 
most helpful in making the patient comfortable. 

Tying the Cord Very Important. 

Occasionally births occur when only the nurse 
is present; every nurse should understand the 



BETTER BABIES 43 

tying of the cord and when it is to be tied and 
severed. Statistics show that a child will gain 
from one to three ounces of blood by delaying 
the severing of the cord for several minutes 
after birth, and children are made more robust 
by this judicious delay. A suitable material for 
tying the cord is a narrow linen bobbin which 
can be dipped into an antiseptic solution, or 
sterilized, or bought from a drug store already 
properly prepared. The cord should be tied 
from two to three inches from the navel, and, 
as I have said, when the physician can not be 
reached, this service sometimes must be per- 
formed by the nurse or other attendant. 

Preparations for the Child Itself. 

Of course every mother makes careful prep- 
arations for her expectant baby, and this is 
left largely to her own judgment, but the fol- 
lowing list of garments, necessary for the little 
one as well as the suggestions for the mother 
herself, are issued by the Russell Sage Founda- 
tion in a pamphlet written by Dr. Frances 
Bradley, and the list covers the ordinary con- 
finement needs most suitably: 



44 better babies 

List of Necessary Things. 

For the Baby: 

Y± yd. thin, light weight flannel. 

2 light weight woolen blankets. 

3 cotton and wool undershirts. 

4 flannel skirts. 

3 long outing flannel gowns. 

6 cotton slips. 

2 doz. diapers 1 8 in. 

2 doz. diapers 22 in. 

1 box boric acid. 

1 box talcum powder. 

1 piece Ivory soap. 
34 lb. sterile gauze. 

34 lb. sterile absorbent cotton. 

2 doz. safety-pins, large and small. 

For the Mother: 
6 gowns. 
1V2 yd. square oil cloth or rubber sheeting. 

3 yds. unbleached muslin. 
2 lbs. absorbent cotton. 

2 lbs. sterilized gauze or equivalent in old 
clean cloths. 



BETTER BABIES 45 

NEW NAVEL BAND AND THE BETTER 

WAY OF PUTTING A DIAPER 

ON A BABY. 

"Dress reforms" for adults are constantly 
being discussed and tried, and it is interesting 
for the physician to believe that many of these 
are actuated by a growing consideration for 
health and sanitation. In fact, I have always 
believed that the attention of the true physician 
should be directed as closely and carefully to 
preventing disease, deformity, and death, as it 
is to combating these conditions when they exist 
or threaten. It was because I, myself, try to 
adhere to this general principle, that my atten- 
tion was attracted to what might at first appear 
a very trivial thing, but a thing which I firmly 
believe might well cause some complex and in- 
explicable physical conditions, the source of 
which we can trace in no other way. 

We have all observed the gradual changes in 
the dress of our women, and we who have made 
any study of historic conditions will recall, for 
instance, the iron bound stays of the dress of 
"Good Queen Bess" of an earlier century, 
which we would consider absolutely barbarous 
to-day. Then, too, our women to-day are not 
all fettered by ridiculous heels to their shoes, 



46 BETTER BABIES 

half a foot more or less in height, nor are they 
choked with tight collar bands reaching to the 
ears, while the compressed waist, which "can 
be spanned with an open hand," is now a thing 
of the past. Extremes of dress we see, of 
course, but, as a general rule, these are grad- 
ually being displaced by modern good sense, 
and fashion itself has set the pace for a health- 
ier, heartier, happier race of women. 

But despite the changes in the dress of our 
women, there has been comparatively little 
change in the dress of our infants. This is. 
practically the same as it has been within the 
memory of man, but it is not too late for fash- 
ion and science to join hands and declare for at 
least one radical change in this particular also. 
Within the very recent past, the swaddling 
clothes have grown a little shorter, and the con- 
venience of the mother and comfort of the baby 
has been subserved thereby, but it is to another 
and a really vital change that I refer now, and 
to which I wish to call most particular attention; 
this is to the adjusting of the very necessary 
diaper and band, the latter being better known 
as the binder. 

I think every thinking person will be im- 
pressed with the necessity for changing the old 
method of encasing the infant in a tight band — 
tight enough to stop its breathing, almost, and 




UK OLD WAV OF PUTTING OS THE NAVEL BAND OR BINDER; 
THE PINS, THE UNNECESSARY WIDTH, THE TIGHTNESS 
AND THE GENERAL DISCOMFORT AND DANGER OF THIS 
METHOD MAKES THE BABY FEEL AS QNCOMFORTABLE AS 

IT LOOKS. 




■UK NEW NAVEL BAND; NO PINS. NO BINDING, NO DANGER 
AND NO DISCOMFORT. MADE OF ELASTIC STOCKINET IT IS 
Soft, FIRM, DURABLE, EASILY LAUNDERED AND SAFE. 



BETTER BABIES 47 

certainly tight enough to be desperately uncom- 
fortable. I have seen many babies swathed in a 
heavy flannel or linen binder, when all that is 
really needed, for the first three weeks or less, 
is a bandage which will securely keep the navel 
dressing in place. 

After much experimenting, I have at last 
found a perfectly sanitary, safe, and satisfac- 
tory binder, and one which is simple, practical, 
and inexpensive. Too often we find a child suf- 
fering apparently from a severe colic, when the 
condition is in reality caused by a too tight 
binder and an uncomfortable diaper. I can say 
that at last I have found an ideal binder, which 
is elastic, firm, and which fits snugly around 
the abdomen. Such a binder must be about four 
inches wide, and the first kind I discovered was 
called a "Bender's Bandage," the material being 
elastic, sanitary, and with the quality that 
KEEPS ITS SHAPE AND SIZE. This ban- 
dage is not now imported as freely as it was 
before the European war, and as we can find 
almost everything now "made in America," I 
think that Mann Universal Elastic Bandage is 
an excellent substitute for the Bender's Bandage, 
if the latter can not be procured. The Mann's 
Elastic Bandage comes in two weights, and I 
find the lighter weight is, perhaps, best adapt- 
ed for the purposes we have in mind. This ban- 



48 BETTER BABIES 

dage is sanitary, it can be easily washed, is not 
expensive, and is practically everlasting. 

The method of making this binder is to take 
the measurement of the child's abdomen across 
the navel, then cut the bandage from one and a 
half to two inches smaller than this measure- 
ment, and sew together with a flat seam; that is, 
one that is either machine stitched on each side, 
or "cat-stitched" down the middle, thus in- 
suring smoothness without bulk. The seam 
really makes no appreciable impression in the 
stockinet, and merely adds to its strength. 

Of course the navel dressing needs no binder 
after the first month, at the utmost, and at that 
time I usually advise the use of the abdominal 
band suspended from the shoulders, but until 
it is possible to use such a band, the elastic band 
is, or should be, a necessity. In adjusting this 
elastic binder, the infant's feet should be put 
through first, thus avoiding undue stretching 
and enabling the navel dressing to be kept per- 
fectly in place. 

For fifty cents, four such elastic binders can 
be made, and by their use, it is possible to ab- 
solutely avoid that abdominal pressure so com- 
mon with the old style binder, and which causes 
infant vomiting when the stomach is filled with 
food, and which so often causes real harm when 




WING BONES 

I I N I ( ' IMS 
ED PREJS- 



BETTER BABIES 49 

the distended stomach is pressed against an 
immovable bandage. 

I can not too strongly urge on every physi- 
cian the consideration of the elastic binder, nor 
can I too strongly plead with every mother and 
nurse to adopt it at once. Indeed, a single trial 
will convince any one of its practical usefulness, 
as well as of its sanitary advantages. 

The Adjustment of the Diaper. 

But there is still another radical change in 
the dressing of infants and young children, to 
which I wish to call the attention of physicians, 
nurses, and mothers. While this change may 
seem trivial at the first glance, I feel certain that 
a careful consideration of the situation will con- 
vince my readers that my points are all taken 
from perfectly practical view-points, as well as 
from sound theories. I believe, too, that when 
you have followed by course of reasoning, you 
will agree with me that the time has come for 
every mother to change her old methods of ad- 
justing her baby's diaper. I well know that for 
generations this article of dress has been left 
solely to the mother and nurse, but I know, too, 
that I have many times seen the soft skin of a 
baby's tender abdomen circled by a tense red 
line, where the diaper has been ruthlessly pulled 
around the little form, with the one idea in 



50 BETTER BABIES 

view — that of protection and personal neatness. 
While no one could more strongly advocate per- 
sonal neatness than I do, at the same time I 
am glad to say, that by adopting the new 
method I will describe to you, you can at the 
same time preserve the most extreme ideas of 
neatness, and also guard the baby's future 
health and usefulness. 

I wish I could claim to have invented this 
new method, but all the credit I can claim, if 
credit of any sort there is, is that of recognizing 
the possibilities involved in a suggestion which 
came to me, through a Chicago woman who 
brought her baby to me for treatment. When 
I took the rectal temperature of the baby this 
mother brought to me for treatment, I was in- 
stantly attracted by the novel method which the 
mother had used in adjusting the child's diaper. 
Instead of the usual plan of folding the diaper 
in a triangle, with the point pulled upward and 
the ends fastened tightly around the waist, this 
mother had folded the napkin in a long strip, 
and had cut the cloth almost square, although 
it was a trifle longer than wide. To fasten this 
napkin, two safety pins were used, one on each 
hip of the child; thus securing the napkin com- 
fortably, perfectly, and at the same time afford- 
ing the ample protection needed, while at the 
same time absolutely avoiding undue pressure 




NO. 2 X BAT OF INFANT PELVIS WITH DIAPER BELD IN 
POSITION BT LARGE PIN, DRAWING PELVIC BONES IN- 
WARD. CAT 8INQ BLIGHT CURVATURE OF LEFT THIGH. 




NO. 3 -INTERIOR VIEW OF INFANTS ABDOMEN; SUBJECT 

DIED AT BIRTH. SIGMOID SHOWN TO RIGHT; FORCEPS 

POINTING TO UTERUS; BLADDER AT LEFT OF UTERUS 
EMPTY. 



BETTER BABIES 5 I 

on any organ or set of organs. I asked the 
mother immediately why she used this method; 
her reply was, that it had seemed to be "more 
comfortable," and at once my mind was busy 
as to the many reasons why this should be 
exactly true. "More comfortable," I thought, 
"in every way, not only for the child at the 
moment, but for the physical health of the adult 
in the future." 

I could easily picture the relief, to a child, of 
the tight binding across the lower part of the 
abdomen, which is usual in the ordinary ad- 
justment of the diaper, and which I am con- 
vinced is a factor in producing so many intes- 
tinal disorders. For instance, it is only natural 
that gas, which very often forms after the diaper 
has been adjusted, could cause distension and 
pressure which would become acutely painful. 

Another point also occurred to me in this 
connection; the majority of people are right- 
handed, and for this reason a sharp pull is 
given from the left toward the right when the 
diaper is adjusted, and this brings the pressure 
directly over the sigmoid, which is found on the 
left side, and which holds the fecal matter until 
dispelled. The pressure here, and over the 
lower part of the abdomen, is no doubt one of 
the main causes of intestinal stasis in infants, 



52 BETTER BABIES 

for it is a fact that seven out of every ten in- 
fants, whether fed at the breast or artificially 
fed, are constipated. 

Pelvic Bones Pliable in Infants. 

We have already discussed the dangers of 
the tight binder, and it is safe to assert that the 
combination of tight binder and torturing diaper 
form an absolutely cruel method of dressing an 
infant, and yet one which custom has made as 
universal as infancy itself. Not a few mothers 
want the diaper and the binder to fit as snugly 
as a corset, and in such a combination we have 
a pressure quite as unnatural as the foot binders 
of the Chinese or the iron stays of the days of 
Good Queen Bess, and certainly a thousand 
times more dangerous to the soft tissues of the 
child. 

For many months I have carefully investi- 
gated the texture of the bones of the pelvis in 
infants, and I have found these bones quite as 
pliable as the other bones in an infant's body. 
Parvin, authority on diseases of women, in an 
eld work, and also some of our most modern 
authorities, tell us that the pelvic bones in early 
life are composed of three bones, and that the 
ossified union between them is not complete un- 
til the subject is eighteen or twenty years old. 
These same authorities state "that just as no 




NO. 5— OLD METHOD A LITTLE TIGHTER : SITTING CHILD UP- 
RIGHT, CROSS PIN DIGGING INTO ORGANS BENEATH ; IN 
FEMALE, UTERUS ESPECIALLY INVOLVED. PELVIS MADE 
NARROWER RY THIS CONTINUAL PRESSURE. 



BETTER BABIES 53 

two human faces are alike, no pelves can be 
found which do not present some differences, 
and, in addition to this, it is further claimed that 
no pelvis is perfect in symmetry and form or 
normal in measurements." While it is difficult 
to state positively that our infants are born with 
these pelvic differences, and even though the 
sacrum and coccyx complete the pelvis poste- 
riorly, my conclusion as to the possible effect of 
the diaper would not be altered. 

From all of which, therefore, we can see 
that by making greater, persistent, and undue 
pressure around the pelvic bones the anterior- 
posterior diameter is slightly lengthened and the 
transverse made narrower, and by making 
greater pressure on the left side than on the 
right it would unbalance the normal pelvis even 
if the bones were normal, and more so if 
rachitic. In considering the effect of the mis- 
used diaper we must bear in mind that it is a 
bandage worn twenty-three hours out of the 
twenty-four, and in the majority of cases until 
the infant's eighteenth month, while it is not 
unusual to find this garment on a child two 
years old. 

As all physicians know, neither the uterus nor 
bladder takes its proper place in the pelvic 
cavity until the child is at least six years old, 
hence during the entire period when the diaper 



54 BETTER BABIES 

and binder are used, the unnatural pressure is a 
menace; in fact, until the twenty-fifth year, 
danger may exist, for not until that time is the 
bony union complete. 

In considering the question of dressing our 
infants, we might well glance backward a little 
and learn a valuable lesson from our Indian 
forbears. The Indian papoose has a diaper, it 
is true, but it is a garment of soft cloth, and this 
cloth is rolled around the Indian infant; it is 
not even pinned in any one place, but the baby's 
entire body is left as Nature intended it to be; 
comfortable, and straight, and unhampered by 
any of the artificial dressings which have been 
adopted by modern society. Who shall say that 
much of the female health and strength among 
the Indian tribes is not due to this very reason? 
Certain it is that Indian women bear children 
easily; that instrumental delivery among them 
is almost unknown, that they seldom have any 
form of pelvic disorder and research shows that 
the Indian women dress loosely from infancy to 
old age and that her general health is pro- 
verbially good — there MUST be some reason 
for this. 

It may indeed be possible that the very ques- 
tion I am discussing may furnish an explanation 
of this Indian health. The outdoor life which 
the Indian woman leads, the hard work she 





1 


1 


1 

• - 

1 




J 



NO. '". NEW METHOD FOLDING DIAPER; HAVE MATERIAL A 
LITTLE LONGER THAN WIDE, AND DIAPER SHOULD BE A 
LITTLE WIDER THAN BABY'S BODY. 




NO. 7— SIT BABY IN DIAPER TO ADJUST; TAKE LOWER CORNER 
AND BRING FROM INNER PORTION OF THE THIGH TO 
OUTER PORTION <»E HIP; THEN REPEAT SAME PROCESS 
WITH OTHER SIDE. USING TWO PINS; ONE ON EACH HIP. 



BETTER BABIES 55 

does, and the coarse food she eats, could not 
furnish the reason. It seems to me, then, that 
it must be her manner of dressing. Of course, 
I do not advise our women of to-day to give up 
a correctly fitting corset, nor one that furnishes 
proper support where needed, nor do I advocate 
a return to the dressing of the Indian women. 
But I do insist that the soft bones of our infants 
be left unhampered, for I certainly do believe 
that there is some fundamental reason for much 
of the discomfort, danger, and disease, prev- 
alent in our social life to-day. Neatness in 
woman's dress is essential; neatness in caring 
for our infants is equally necessary; but neatness 
and health are absolutely compatible, whether 
in infant or adult, and this is what will be 
proved by all who try this new method. 

Conditions Produced by the Old Method 

Before attempting to describe exactly the 
method of adjusting the diaper in the new way, 
I wish to consider a little more carefully the 
conditions produced by the old method. We 
must remember that the fundus of the uterus 
is on a line with the anterior spinous process; 
that the bladder, when full, rises a little higher, 
and that when you put on a baby's diaper, tight 
or loose, and pin it in the center with a large 
safety pin, and then sit the child up, it is easy 



$6 BETTER BABIES 

to imagine what takes place underneath the arti- 
ficial bandage, especially, as often happens, 
when the long ends of the triangle are knotted 
and forced underneath the front point. This 
latter practice makes a hard lump, pressing deep 
into the lower abdomen, and it would be won- 
derful, indeed, if deformities did not result 
from such a condition. I say, again, I believe 
that deformities DO result from this very prac- 
tice, and there are many ways of proving it 
almost conclusively. 

For instance, I have heard a fashionable 
dressmaker, as well as a popular tailor, state 
that the female form is found to be larger on 
the right hip than on the left, in seven out of 
every ten cases. This is the more noticeable in 
females, where garments are fitted carefully 
over the hips, than in males, but if this is in- 
deed a fact, why might it not result from pres- 
sure brought to bear on the left side during in- 
fancy? Such pressure would inevitably prevent 
the normal development of the left side, while 
the right side, unfettered, grows to its full size. 

We all know how common uterine and other 
pelvic displacements are in women; possibly we 
have all heard it said that these disorders are 
"congenital;" but are they? Why might not 
the majority of these serious and harrassing 
troubles result from the very conditions we have 




O. 8 THIS SHOWS 
WITH BAND OB I 
SMALL PIN TO KI-: 



•NT VIEW OF NEW WAY COMPLETED 
tSHIBT ATTACHED TO DIAPEB WIT1 
tOTH GABMENTS IN POSITION. 




NO. 9— REAR VIEW OF BABY WITH DIAPER ADJUSTED IN NEW- 
WAY. SMALL PIN "AN ATTACH TO SHIRT OR BAND IN 
BACK IF DESIRED. 



BETTER BABIES 57 

been discussing, and why, if this is even a pos- 
sibility, can we not begin at once to prevent such 
deformities in the future generations? Moth- 
ers, this is a question for YOU, even more than 
for your nurse or your physician, and I sincerely 
hope you will give it careful consideration. I 
know it is a new idea, but when we remember 
that new ideas are the stepping stones to prog- 
ress, surely we can safely venture to consider 
them and to adopt them, especially when they 
refer to so vital a matter as the dressing of our 
infants, when this dressing influences the de- 
velopment of the child. 

I hope a careful study of the photographs 
accompanying this article, and a slight study 
of the directions beneath each one, will easily 
instruct any mother in the new method of ad- 
justing the diaper, and I hope, too, this method 
will soon be universally followed. 

At a Child Welfare Exhibit held in Atlanta, 
Ga., in the fall of 19 14, which was held under 
the direction of the National Child Welfare As- 
sociation, I used a life-sized doll to demonstrate 
this new method of putting on the diaper. The 
nurses in charge of this exhibit told me it was 
the most attractive and most crowded demon- 
stration of the entire exhibition. Again, when 
a mammoth "Better Babies" Contest was held 
in Atlanta, during Harvest Festival Week of 



58 BETTER BABIES 

191 5, I used a life-sized doll to demonstrate 
both the binder and the diaper, and hundreds 
of mothers learned the new methods at that 
time. They seemed to accept at once the im- 
provement indicated, and to be anxious to adopt 
them. 

Physicians, nurses, and all interested persons, 
who have seen the photographs I have exhibit- 
ed, and who have heard me speak on the sub- 
ject of the new methods for binder and diaper, 
are enthusiastic about them, and it is my earnest 
hope that no mother who reads this book will 
be tempted to put aside my suggestions without 
at least giving the plan a trial, and testing its 
merits for herself. 



DEVELOPMENT. 

There are certain fixed rules by which an in- 
fant's development may be decided, and the 
normal infant will measure very closely to these 
figures. At birth, the circumference of the head 
is about 13^4 inches; the chest is about the 
same; but at one year, the head is from 18 to 
i8>4 inches while the chest is still of the same 
measurement as the head. 

At the third year, the chest is usually a half- 
inch more in circumference than the head, while 



BETTER BABIES 



59 



in adult life the head is about 21 to 21 y 2 inches, 
and the chest is 30 inches or more. From this 
it will be seen that the chest increases gradually, 
but more rapidly than the head. 

The anterior fontanelle should gradually 
grow smaller, and unless the infant be rachitic 
(see special article), should be entirely closed 
by the eighteenth month. 

Some infants have very little hair at birth, 
while others have a growth one or two inches 
in length. In most cases, this growth begins to 
be shed during the first week and continues for 
several weeks thereafter, until quite a bald spot 
is noticed on the back of the head, due to the 
friction of the head on the pillow. The hair is 
at first very soft and silky and, when it begins 
to grow back, is several shades darker than at 
birth. 

The baby's mind is steadily growing and 
keeping pace with its body and mothers often 
believe that the baby recognizes her, as it often 
smiles. But this, I believe, it does not know 
itself, so the mother's idea is pretty, though 
scarcely practical. 

The baby nurses from a sort of intuition; it 
is sensitive to heat or cold; and at about the 
third month the normal baby can grasp at an 
object. At the fourth month it can hold its 
head erect, and at the sixth month it can notice 



60 BETTER BABIES 

and play with toys, while at the seventh month 
it can "sit loney," but should be allowed to do 
this only for a very short time. 

At about the tenth month a baby is able to 
stand and have the legs bear the weight of the 
body, but this should be carefully regulated, as 
often bow legs are caused by the use of the legs 
too soon and for too long at a time. The over- 
anxious mother may be tempted to encourage 
the baby to stand too long, even when it is 
holding to a support. 

At about the eleventh month the baby should 
be able to "stand loney" and, unless it is sick, 
by the twelfth month it should be able to take a 
few steps. Babies who have been crawling on 
the floor, however, are usually slow walkers, for 
somehow they seem to lose confidence in them- 
selves or in the new way of locomotion. No 
mother should endeavor to make her baby walk 
just because some neighbor's baby is walking; 
while this may be perfectly normal for some 
babies, it may also be hard for others; there is 
no fixed rule about walking, standing, or sitting, 
or, in fact, about any process a baby undergoes; 
the facts and figures given are just generaliza- 
tions taken from certain groups of babies, but 
may not apply exactly to any one of the num- 
ber. 



BETTER BABIES 6 I 

A baby usually hears about the time it is a 
few weeks old, hence loud noises made near the 
baby should be avoided. About the sixth or 
seventh month the baby will begin to make 
sounds, words with "m" and "ah" being the 
first ones used. Fond mother and grandparents 
interpret this babbling into an effort to say 
"Mamma," but this does not usually happen 
much before the first year, when a baby does 
really say "Mamma" and "Papa" and knows 
what it is saying. 

During the second year the little one will 
begin to learn the names of animals and ob- 
jects. Animals are usually given names of the 
baby's own invention; for instance a dog is a 
"Bow wow;" a cow is a "Moo — oo," etc. 

Do Not Frighten Baby. 

Baby should NEVER be frightened or 
threatened. Scolding should be avoided and 
the little one should be reasoned with gently 
and patiently, but under no circumstances fright- 
en it. It is particularly wrong to use the "Doc- 
tor" or the "Policeman" to intimidate the baby. 
Both of these semi-public characters are often 
needed in the baby life, and should be friends 
of the little ones, not objects of terror. Then, 
should baby be lost, the policeman will naturally 
bring it home; and if the little one should be ill, 



62 BETTER BABIES 

the doctor will help it to get well. If physician 
and policeman are used as "bugaboos" for the 
baby, it will be hard for either one to be useful 
to it when needed. 



CARE OF THE EYES AT BIRTH. 

Within the comparatively recent past, physi- 
cians have given the proper consideration to 
care of the infant's eyes at birth. This con- 
sideration is the result of investigations, which 
have proven that a very large percentage of 
the cases of so-called "congenital blindness" are, 
in reality, cases of PREVENTABLE blindness, 
the preventive measures being simple, effective, 
and very easily taken. 

As soon as the child is separated from the 
mother, that is to say, when the ligature of the 
cord is complete, the child should, of course, be 
wrapped in a clean warm blanket, and, im- 
mediately, the lids of the eyes should be washed 
with a saturated solution of boric acid. But this 
is merely an external precaution; the lids should 
then be separated and the same solution, drop- 
ped from sterile cotton or gauze, should be 
allowed to thoroughly wash out the INSIDE of 
the eye; then two drops of a two per cent, solu- 
tion of nitrate of silver (Credes Method) 



BETTER BABIES 63 

should be instilled into the eye by means of a 
glass medicine dropper. This latter treatment, 
however, should only be administered by a phy- 
sician, and he should also examine the vaginal 
secretion of the mother. If this is done before 
and after birth, much of the infantile blindness 
could be prevented, while the treatment of the 
infant's eyes, as outlined above, would be mere- 
ly an adjunct or a precautionary measure. 

I would not advise nurses to use the nitrate 
of silver solution, but would suggest that when 
there is no physician in attendance a twenty-five 
per cent, solution of argyrol be used, five drops 
being put INTO the eyes, and NOT on the 
lids, as is so commonly done. Without these 
precautions, Opthalmia Neonatorium will creep 
into even the best regulated families, and this 
question is one that must be squarely faced, for, 
by so doing, blindness in a great number of in- 
fants can certainly be prevented. 

Registered Physicians ONLY Should At- 
tend Such Cases. 

Perhaps it is as good a place as any for me 
to say right here that this subject of preventable 
blindness is so important, so grave, and so far- 
reaching, as to warrant the passing of the most 
stringent international laws on the subject. By 
such laws, every person attending a case of labor 



64 BETTER BABIES 

should be required to be duly registered at the 
local board of health, and should be duly ex- 
amined, by such authority as the board of health 
may designate, in order to prove the efficiency 
of the person to conduct a case of labor and to 
CARE FOR THE EYES OF THE CHIL- 
DREN BROUGHT INTO THE WORLD 
UNDER HIS CARE. 

Our asylums for the blind, in this country and 
in Europe, are filled with these preventable cases 
of blindness, and there can be no subject more 
fraught with the public good than the preven- 
tion of such cases. Here, indeed, to my think- 
ing, is a field for the work of organized women 
in clubs, churches, and communities of all kinds. 
Legislators, local and national, should be ap- 
proached with properly prepared bills designed 
to prevent blindness of such children as may be 
born into the world to-day, and I do believe that, 
once the simple preventive measures are better 
understood, and the reasons for them more fully 
appreciated, public sentiment and public knowl- 
edge will so control the situation that we will 
be free from this menace, to the future useful- 
ness of our citizens. 



BETTER BABIES 65 

BATHING A NEW BORN INFANT. 

The first bath is usually given a new born 
infant soon after it enters the world. The tem- 
perature of the water used for this bath should 
be 100 degrees F. A bath thermometer for this 
purpose should always be used, and can be 
bought at any drug store. The hand of the 
adult, so generally used to "see if the water is 
right," is no test for the baby. The room in 
which this first bath is given should always be 
warm, and, even in summer, it is well to have a 
small wood fire when the baby is first bathed. 
The bath should only last a very few minutes, 
and the baby should be thoroughly dried, either 
with the cheese cloth already suggested, or some 
other soft absorbing material. Here, too, a 
good talcum powder should be used, by being 
rubbed gently all over the body, especially in 
the folds of the skin. 

The cord should be washed with an antiseptic 
solution, dried gently, and dusted with a powder 
composed of one part of salicylic acid to seven 
parts of boric acid. A piece of sterile gauze 
should then be placed over it, and the navel 
band adjusted. This band I will describe in 
detail elsewhere, but I will say here that it 
should be held in place until the cord drops off, 



66 BETTER BABIES 

which will happen in normal cases in about a 
week's time. Until this occurs, the infant should 
have only sponge baths, but immediately there- 
after the full tub bath may be resumed, with 
the temperature of the water about 98 degrees. 

By the sixth month, the temperature of the 
bath can be given at 95 degrees, and by the 
first year, at 90 degrees F. 

I can not too strongly urge the necessity of 
the daily bath for the infant and young child; it 
has been said that babies breathe largely 
through their skin, but, be that as it may, no 
child can be absolutely sanitary if it is not given 
a daily bath, at a regular time, and with all due 
precautions, a mere outline of which is given 
here. 



CARE OF THE BABY'S SKIN. 

The delicate nature of the construction of an 
infant's skin, and the importance of its func- 
tions, necessarily makes its care a matter for 
careful consideration. The skin responds 
readily to external and internal agencies, and 
conditions of the heart, lungs, and intestines are 
registered on the delicate skin of an infant. 
Externally, the skin is so delicate that it must 
be carefully protected from irritants of all sorts, 
such as too heavy clothing, especially during 



BETTER BABIES 67 

the heated term, as this causes prickly heat and 
other trying conditions. The skin between the 
groins and over the buttocks should be protected 
from urine and feces as much as possible, for 
these cause at times a very severe inflammation, 
and even eczema and other diseases. Absolute 
cleanliness should be observed with infants on 
this account; the napkins should be changed 
often, irritating soaps and rough wash cloths 
should be avoided, and the infant should be 
thoroughly dried after bathing, and whenever 
the napkin is changed. I think, too, that the 
best towel for an infant during its first months 
of life is cheese cloth, which has been washed 
and made sterile, and even when this soft cloth 
is used, the infant should be PATTED and not 
rubbed dry. A bland, pure, absorbing powder 
should always be used after drying the infant, 
and this should be put into the folds of the 
skin, particularly; that is to say, about the neck, 
under the arms, in the groin and on genitals. A 
very good powder consists of the following: 

Eucalyptol, 10 drops. 

Boric Acid, 4 drachms. 

Talcum, 3 ounces. This can be mixed at any 
drug store. 

If the parts in the groin become inflamed, 
use the powder freely, and cover with a piece 
of sterile gauze or cotton to prevent friction. 



68 BETTER BABIES 

My advice to all mothers is, that as soon as 
there is the slightest discoloration or eruption 
of the skin, to call a physician at once. It is a 
thousand times easier to prevent a skin disease 
in an infant, than to effect a cure after such 
a disease really exists. 

I shall not attempt to discuss here the va- 
rious disorders of the skin, or their treatment, 
but this much is merely suggestive, and given 
as a reason why you should consult your own 
doctor rather than accept the advice of any one 
else on this subject. 



SLEEP. 



The new born baby should sleep nearly all 
the time, except when nursing or having its 
toilet made. Sleep is a good sign that "all is 
well" with the youngster. 

The average baby sleeps about twenty hours 
a day for the first few weeks, and as it grows 
older it sleeps less and less, until at the age 
of one year, it sleeps about sixteen hours out 
of the twenty-four. 

Happy are the mother and nurse when baby 
sleeps well, and it must be remembered that 
training has much to do with giving the baby 
regular sleeping habits; it will prove indeed a 
blessing to the mother to inculcate such habits 



BETTER BABIES 69 

as early as possible in the baby, for the baby 
who sleeps irregularly and fitfully soon becomes 
an actual menace to the comfort of a home 
for it keeps the household disturbed day and 
night. Rocking the baby to sleep, walking the 
floor with it during the night and singing "sweet 
lullabies" should be actually prohibited by law! 
The baby should be put to bed and then left 
in the room alone, and the light turned out; the 
latter is necessary, for it is better for the baby 
to sleep in a dark room, and if it is allowed to 
grow accustomed to sleeping with a light in the 
room, it will awaken as soon as the light is 
turned out. I would advise some one to remain 
in the adjoining room after baby is put to bed, 
just to be sure it goes to sleep all right; some- 
times accidents happen to the baby when it is 
old enough to climb up in its crib and possibly 
to fall out. 

For infants, the sleeping basket or bassinet 
should be used during the first few weeks, and 
these can be bought at any department store 
where baby goods are sold. For the baby as it 
grown older, the white enamel crib, with sides 
that can be lowered at will, is the best and most 
sanitary bed, and if bought large enough at 
first it can be used until the third or fourth year. 
Such cribs should be fitted with a hair mattress 
and a small hair pillow, although the latter is 



70 BETTER BABIES 

seldom used. A rubber sheet should be spread 
over the mattress to protect it from feces and 
urine. Over this rubber there should be a large 
quilted pad. If the napkins are wet in bed 
and this pad becomes wet also it can easily be 
removed, thus leaving the bed dry. Of course 
there should be a soft sheet to cover the baby, 
and on top of this a warm light blanket of 
flannel. The baby should never be covered too 
warmly, as all babies perspire freely when 
asleep, and if covered too warmly are liable 
to take cold, which may result in some con- 
gestion of the internal organs. 

Soft warm blankets should always be on hand 
to increase the baby's covering during the night, 
in case there is a sudden change in the weather, 
and care should always be taken to have the 
coverings kept on the baby during its sleep. 
There are many ways of doing this, and almost 
every mother has her own particular plan. But 
I would advise all mothers to see to it that while 
baby's covering is kept snugly in place during 
the cold weather, and especially over its feet, 
that the blankets be not pinned down too tightly, 
so that the baby can not move easily beneath 
them. Some department stores are showing 
various devices for this purpose, and it would 
be well for mothers to examine these and note 
the principles on which they work. 



BETTER BABIES 7 1 

CRYING. 

The normal infant cries for several reasons. 
It is always fortunate when the baby does cry 
at the very first, for this is just what the doctor 
wants it to do. By a first lusty crying the baby 
expands its lungs, clears its throat of mucous, 
and also sends the blood to all parts of the 
body. In fact, if the baby does not cry im- 
mediately after birth, it is spanked, or treated 
to a spray of cold water thrown into its face. 
But after this first protest, as it were, against 
coming on the earth, the baby seldom cries 
afterward unless for some cause. 

Usually when baby cries, it is either hungry 
or in pain; if the former is the case, nursing 
ends the crying, but if the crying continues 
after the nursing period, then there is some 
other trouble. Sometimes the baby is thirsty, 
especially during the summer, and it is well to 
give water, when the cry will soon be ended. 

There are different sounds to a baby's cry, 
which the observant mother will soon begin to 
distinguish. The cry of a pain from colic is 
sharp and loud, and different from the short 
catchy cry of pneumonia, or the hoarse cry of 
laryngitis (croup), while the crying from ear- 
ache or other pains, such as pin sticking some 



72 BETTER BABIES 

where, or discomfort from a too tight band or 
an uncomfortable diaper, also has a different 
sound. The feeble whine noticed in a baby suf- 
fering from marasmus and the sharp cry when 
it is handled indicating scurvy, should also be 
recognized and separated from the cry of dis- 
comfort when it needs to have the soiled diaper 
removed, or some other attention given it. 
Often babies cry from fright, or temper, or even 
from mere sleepiness, so a cry is not a signal for 
alarm on the mother's part, unless it is persist- 
ent and resists any and all the small attentions 
which she may pay the child. Then, of course, 
she should at once have the baby examined by a 
physician, but at other times it is well to re- 
member that "an infant crying in the night, an 
infant crying for the light, it has no language 
but a cry." 



EXERCISE AND AIRING. 

Even the infant requires exercise, but like 
the average adult, it is seldom given enough 
exercise, or even the opportunity to take it. 
Baby's clothing should never be too tight, for 
this restricts the free motion of the arms and 
legs. Of course long clothes prevent the free 
movement of the baby's limbs, but until the 
short clothes are put on, the baby should be 






BETTER BABIES 73 

allowed to kick and move its arms freely once 
a day. For this period of exercise the baby 
should be put on the bed, clad only in its band 
and diaper and then covered with a warm, soft, 
light cover, and allowed to lie there for a time. 

The lungs usually receive sufficient exercise 
from crying, and this is Nature's provision for 
developing the lungs, so it must be an imperative 
necessity. 

When the baby is a month old, especially 
during the summer, spring, or fall, when the 
weather is mild, it should be taken out for its 
first airing; a half hour is long enough for the 
first time, and this time should be gradually in- 
creased as the baby grows older. If baby is 
born during the winter months, it is well to wait 
until it is at least two months old before taking 
it out, and then it should be taken out only on 
good clear days. 

However, if the baby is born in winter, it 
can be aired indoors as early as one month 
after birth. To do this it should be dressed as 
for outdoors, all the windows in the room 
should then be opened, and the baby placed in 
its carriage and left for half an hour in the 
room. 

I would advise the use of a carriage for 
baby's outings, but care should be taken in put- 



74 BETTER BABIES 

ting it in properly, with back and head support- 
ed, and the carriage should be pushed carefully 
to avoid all bumps. The rubber tired carriages 
fitted with good springs are safe for a baby. Its 
eyes should be well protected when it is taken 
out in the carriage, and in cold weather the feet, 
hands, and body should be well covered to avoid 
a sudden added chill in the atmosphere, which 
might be very harmful to the tender young life. 



WEIGHING THE BABY. 

Because baby's weight is an important factor 
in its development, every household in which 
there is a little one, should have a suitable scale 
on which to see if the hoped for and expected 
gain in weight is made. By this means only 
can we determine whether the nourishment given 
a young baby is correct; often the stools are ap- 
parently normal, and other general conditions 
seem to be likewise, but a test of the baby's 
weight will show that we are failing in some 
way to give the little one the nourishment it 
should have. 

At birth, the average baby weighs about 
seven and a half pounds; in two months its 
weight should have increased to ten and a half 



BETTER BABIES 75 

pounds ; at four months it should weigh twelve 
and a half pounds; by the sixth month it should 
have doubled its birth weight, that is, it should 
weigh about fifteen pounds if it weighed seven 
and a half pounds at birth. 

At nineteen months, baby should weigh eight- 
een and a quarter pounds, and at the end of the 
first year, twenty-one and a half pounds would 
be normal, while at two years, it should weigh 
twenty-seven pounds; at three years, thirty-five 
pounds, and at four years, thirty-eight pounds. 

The most marked increase in weight, of 
course, is during the first year, and for this 
reason baby should be put on the scales at least 
twice a month. There are many sorts of scales 
on the market which are reliable for use of a 
young infant, but after the first year, it is well 
to have baby weighed at some reliable scales, 
either at a drug store or a doctor's office, in 
order that the weight may be accurately known. 

From the foregoing, it will be seen that 
actual avoirdupois is not the test of baby's well 
being, for the weight figures are not excessive. 
The point is to be SURE baby does GAIN in 
weight; if it does not, then something is wrong. 



76 BETTER BABIES 

GOOD HABITS VERSUS BAD HABITS. 

I feel that this book would be quite incom- 
plete and would fail in its usefulness to parents, 
if I did not allude to the power of habit and 
the helpful influence of good habits on a child's 
life, as well as the harm of bad habits. The 
most important point to be remembered by 
every mother, father, grandparent, or attend- 
ant upon a young child, is, that habits are 
formed early in life, and unless good habits 
are cultivated almost as soon as the child comes 
into the world, the chances are that your baby 
will be a nuisance not only to you, but also to 
itself and to every one with whom it comes in 
contact. It is, perhaps, a natural fault for 
mothers, fathers, loving aunts, and the adoring 
grandparents, who think only of their own ten- 
der love for the little one, to indulge this love 
by spoiling the child, upon whom is lavished 
the wealth of affection. But such love is a false 
love, for it does actual harm to the little one 
in many cases. Perhaps this is most clear to 
the physician who is so often called in to at- 
tend, let us say, a case of colic, only to hear the 
fond mother declare, "Why doctor, I feed the 
baby whenever it seems hungry or whenever it 
cries!" Thus by her own indulgence creating 
the very symptom we are called upon to relieve. 



BETTER BABIES 77 

All mothers should understand that every baby 
MUST be nursed regularly, if breast fed, and 
if artificially fed, its bottle MUST be given to 
it at regular intervals, according to the orders of 
the physician. In this matter alone, the intro- 
duction of good or bad habits are not only vital 
to the child's well being and health, but it should 
also be remembered that good habits are as easy 
to form as bad ones, and every child is sus- 
ceptible to routine and to habit-forming. It is 
remarkable to note the apparent facility with 
which a young infant will adjust itself to habits, 
either good or bad. This fact would seem to 
invest the parent with a grave responsibility, 
and I can not too strongly impress upon moth- 
ers this responsibility; for just as easy as it is to 
form a good habit in an infant, just so hard it 
is to break a bad one; hence bad ones should be 
avoided always. Even if a child cries, it need 
not be considered the signal for an immediate 
capitulation to its desires; crying does much less 
harm than overfeeding, for instance, in form- 
ing habits of feeding, it is well to use the clock, 
to follow the doctor's directions faithfully, and 
NOT to be influenced by what may be inter- 
preted as being the child's desire. If this is 
done, the mother will not look and feel worn 
out and exhausted, and the baby will have a 
better chance to be happy, hearty, and healthy. 



78 BETTER BABIES 

The baby should take its nap at as regular 
intervals as it does its food, and should on no 
account be disturbed, except to be fed. Here, 
too, the power of habit will soon assert itself, 
and before many days the baby will wake natur- 
ally at feeding time. If it does not, it may be 
roused gently, fed, and, if it is a normally 
healthy baby, it will go immediately back to 
sleep again. 

.The baby's bath, too, should be given at a 
stated time each day; the best time, perhaps, 
is just before the second feeding in the morn- 
ing. 

Exercise and outings, too, should be given at 
the same time daily, and so accustomed to this 
will baby become that it will fret if the nurse 
is a half hour late! 

The personal habits of a baby should be clean- 
ly, and even as early as the third month it is 
well to begin the use of the little commode. Of 
course the baby should be properly held, its head 
and back perfectly supported. The natural 
position for the bowels to move is thus sitting 
up, and if the baby is put on the commode at 
the same hour daily, and is held there for a 
few moments, after the first few days the moth- 
er will be rewarded by finding that the baby 
knows exactly what to do. About the tenth 
or twelfth month, the same plan should be 



BETTER BABIES 79 

adopted with regard to emptying the bladder, 
and when the infant is two years old it should 
have complete control of the bladder, even dur- 
ing the night. 

Little children, like parrots, are great imi- 
tators, and even to a greater extent than the 
parrot, for the young child will unconsciously 
imitate not only speech but mannerisms, ges- 
tures, and walk. Hence it is well to observe 
oneself, and see to it that the baby has only a 
good example to follow. 

Obedience is one of the greatest factors in 
producing good habits and a good child. There 
is nothing more obnoxious than to observe a 
parent to tell a little one to do this or that, and 
then to be obliged to repeat the command again 
and again, while the "dear little one" does not 
budge to obey. In this case the parent should 
have the punishment, for if the parent begins 
early enough, and understands how to handle 
the child, this will never happen. No child 
is born "mean," but hundreds are made so by 
unwise and injudicious parents. Careless and 
over indulgent mothers and fathers and es- 
pecially grandparents, unite to spoil the ma- 
jority of children, and as I have said before, 
this is all wrong. Be kind to a child always, 
but also be positive with it, and when you give 



80 BETTER BABIES 

it a command, "sit up with it" until the com- 
mand is obeyed. 

No matter what the station in life of the child 
is, the parent should make a companion of it; 
this companionship, which permits you to play 
with your child, and which helps you to enjoy 
it and it to enjoy you, will result in greater 
obedience, for the child will appreciate the close 
companionship of the parent and will respect it. 

No child should be allowed to play in the 
street, day or night; environment is a large fac- 
tor in child rearing, and the environment of 
the street is bad. While a child should be en- 
couraged to be friendly, it should never be bold, 
and boldness is too often the result of indis- 
criminate companionship. 

Certainly I advocate pleasant amusements for 
children, but care should be taken that these 
amusements are not exciting, and that the books 
they read or which are read to them, the stories 
they hear, and the "movies" they see, are enter- 
taining without being over-stimulating to the 
nervous system. Many of the so-called censored 
movies designed for children would well bear a 
little more censoring, and the careful parent 
will not permit the child to indulge in pleas- 
ures ( ?) which are liable to be harmful to it. 

Until a child is three years old it should not 
be fed at the family table, nor, least of all, in 



BETTER BABIES 8 1 

the kitchen. The child should be taught early 
in life that whatever the mother prepares for 
it to eat, is best for it, and it should not be 
permitted to cry for other things. Young chil- 
dren usually want everything they see, and un- 
like the young of any other animal species, they 
will over-eat, and seem to have no conception of 
when they have enough. For this reason, it is 
difficult to teach them table manners before the 
third year, and until that time they should be 
fed in a separate room, nursery, or, if neces- 
sary, in the dining room before the adults have 
their meals. The question of giving children 
proper diet in a proper manner is a vital one, 
and should always receive the mother's most 
careful and intelligent attention. 

Punishment. 

Almost without exception, every child needs 
punishment at some time or another. This, 
however, should never be administered by a 
sharp box on the ear, or by a promiscuous slap 
on the face, nor should a child be shut in a 
dark room or closet, for such methods may do 
actual harm to the nervous system. I would 
advocate a more scientific method of punish- 
ment even than that advised by Solomon; I 
think we can often be permitted to "spare the 
rod" WITHOUT fear of "spoiling the child." 



82 BETTER BABIES 

A punishment that is a deprivation of some 
pleasure or of some outing is often much more 
effective than a spanking. But under all cir- 
cumstances, NEVER BREAK A PROMISE 
TO A CHILD; if the mother promise a pun- 
ishment or a reward, GIVE IT, no matter how 
much she may regret the promise, or how it may 
inconvenience her to keep it. Children are 
quick to observe broken promises, and to take 
advantage of the occasions on which they are 
broken. 

I strongly advise against giving the child 
candies and sweets, "all day suckers," or heavy 
cakes between meals. While judicious sweets 
are not harmful if administered in small quan- 
tities, the digestive system is often permanently 
injured by eating between meals, and by indis- 
criminate eating. 

Pacifiers, nipples stuffed with cotton, and 
finger sucking, may all be placed under the 
general head of BAD HABITS, and while the 
actual injury to the child may not be at once 
perceptible, these habits are bad and they do 
hurt many children. 

I am a strong believer in supervised play; this 
applies to the play of young children as well as 
to those of an older growth. Whether the chil- 
dren of both sexes play together or not, I would 
advise that some adult be near enough to give 



BETTER BABIES 83 

supervision and direction to the play, even 
though this is done apparently in a casual man- 
ner and without the children themselves being 
altogether conscious that they are being watched. 

Bad habits, which often result in serious harm 
to the child, are often formed during play hours, 
when the children are left alone or with other 
children. Many mothers think that their own 
child COULD NOT be guilty of some bad 
habits, but this does not become necessarily a 
fact. I refer principally to masturbation, one 
of the most pernicious and dangerous habits 
which a child can form, and which can 
ALWAYS be prevented by supervision of the 
mother. 

As I have said elsewhere, no child should be 
entrusted to the sole care of a hired nurse; 
especially to the incompetent colored nurses, 
often the very young ones, which we have in 
the South. The nurse is a helper and an as- 
sistant, NOT a substitute for the mother. I 
think one of the very worst habits the mother 
can form, is trusting her child too much to a 
nurse, for this practice often results in very 
harmful habits formed by the child itself. 



84 BETTER BABIES 



THE TEETH. 

There are twenty temporary teeth, sometimes 
called "milk teeth." A few children are born 
with teeth, so that when this does occur there 
is nothing at which to be alarmed. As a rule, 
the first tooth appears at about the seventh 
month, as I have explained elsewhere; this first 
tooth is usually the lower central incisor and in 
a few days its partner also appears. Then there 
is a lapse of from six to eight weeks, when the 
four upper incisors and two lower lateral in- 
cisors appear. The first four molars (or back 
teeth) appear between the twelfth and fifteenth 
month, the canines between the eighteenth and 
twenty-fourth month. Then the four posterior 
molars come between the twenty-fourth and 
thirtieth month, and these complete the first set. 

The Permanent Teeth. 

The permanent teeth are thirty-two in num- 
ber, including the first anterior molars which 
come about the sixth year, and are commonly 
called the "six-year old teeth." 

Mothers should always remember these facts, 
and the teeth should be carefully watched, in 
order that the child may be taken to a dentist 
early enough to prevent decay of the permanent 
teeth. 



BETTER BABIES 85 

The order in which the permanent teeth ap- 
pear is as follows: 

The central and lateral incisors come between 
the seventh and ninth year; the bicuspids be- 
tween the ninth and tenth year ; the canines from 
the twelfth to the fourteenth year; the second 
molars from the twelfth to the sixteenth year; 
and the third molars or wisdom teeth, from the 
seventeenth to the twenty-first year or even later. 

Even in well children, this regularity of cutting 
teeth is not always maintained, while in rachitic 
and ill-nourished children, the cutting of teeth is 
often delayed, and when they do appear they 
show a poor formation of the dentine enamel. 
Teeth in rachitic and poorly nourished children 
decay quickly, causing imperfect mastication and 
consequently poor digestion, ear-ache, neural- 
gia, enlarged glands in the neck; due to absorp- 
tion of toxic matter. 

This subject is treated more fully in a special 
article in another chapter. 



WEANING. 



The baby should never be denied its mother's 
milk unless there is a good reason for it; this 
reason to be determined by the physician. But 
when the weaning period does come, it should 



86 BETTER BABIES 

be done gradually and carefully. It is often 
safe to begin the weaning about the ninth or 
tenth month. The baby at this age might be 
given one bottle a day of properly modified milk ; 
the time for this bottle being to replace one of 
the mid-day meals, preferably in the morning. 
After a lapse of a few weeks, there may be two 
bottles given, and gradually the breast milk dis- 
pensed with. But it is actually dangerous to 
make this change during the summer; if it is 
possible, WAIT UNTIL THE COOL 
WEATHER TO WEAN YOUR BABY. 

Of course no baby should be weaned simply 
because it has colic or abnormal stools; this con- 
dition should be first corrected, as it is often 
possible to do. 

Mothers not infrequently wean a baby be- 
cause their own nipples are cracked and sore; 
this is wrong, as I have explained in a previous 
chapter. If the baby does not thrive at first, do 
not take it off the breast milk, but ascertain if 
the mother is taking proper exercise, diet, etc., 
and is not worrying. This, too, I have explained 
more fully in another chapter. 

Menstruation is not a cause for weaning; 
many women menstruate all during the period 
of lactation. Occasionally, colic and undigested 
stools occur in babies who nurse during men- 
struation, but these soon correct themselves. 



BETTER BABIES 87 

Pregnancy is ALWAYS an indication for 
weaning, as it is impossible for a mother to 
nourish her baby to come and the one already 
in her arms. Acute illness is also an indication 
for weaning, and no mother suffering from 
tuberculosis, epilepsy, syphilis, malignant disease 
of the heart or kidneys, should continue to nurse 
her baby. 



THE PREMATURE INFANT. 

An infant born prematurely, or decidedly un- 
der weight, is certainly a great care and a source 
of endless anxiety to the physician and to the 
parents. Children born weighing less than four 
pounds seldom survive unless, indeed, they are 
given the strictest care and the most unremitting 
attention. All the organs in an infant of this 
weight are necessarily weak, especially those of 
digestion and respiration. The temperature of 
such an infant is also sub-normal, and these facts 
being true, the sheet anchors of those steering 
this delicate craft are heat, breast milk, fresh 
air, and a THOROUGHLY COMPETENT 
nurse. In several of the institutions where a 
number of these cases are cared for, every ap- 
pliance and convenience needed, is, of course, 
easily at hand, but when the premature infant 
comes to an ordinary home, the need for sud- 



88 BETTER BABIES 

denly managing it will cause concern and con- 
sternation. In most cases, the baby should be 
kept well anointed with warm olive oil, and then 
wrapped in cotton batting, and surrounded with 
hot water bottles, or an electric pad, which really 
keeps at a more constant and even temperature 
and can be easily regulated. The baby's tem- 
perature (rectal, of course) can be taken every 
three or four hours the first few days of its life, 
in order to determine whether the vitality is 
being maintained or not. Fresh air must be 
allowed in the room where the baby is kept, but 
the temperature of the room should be warm — 
about 80 degrees F. 

As a rule, the mother is not able to nurse a 
premature infant just at first, so it is best to get 
the breast milk of a wet nurse, and one should 
be chosen who is young; the younger the better. 
To administer the milk this way it should be 
pumped from the wet nurse's breast and should 
be diluted at first in proportion of one to four 
or one to three, etc. 

If, however, it is not possible to secure a wet 
nurse a teaspoonful of warm water given every 
hour, with a medicine dropper will suffice, or a 
three per cent, milk sugar or dextri-maltose solu- 
tion. The Breck's feeder is very convenient in 
giving this water or solution. 



BETTER BABIES 89 

Every effort should be made to bring the 
mother's milk, in order to make the wet nurse 
unnecessary except for a short time. All wet 
nurses are inconvenient and expensive for the 
average family, but occasionally they are acute 
necessities, and the premature baby's arrival 
marks one of those occasions. 



THE WET NURSE. 

Should the mother find it necessary to aban- 
don nursing her baby, she does not, necessarily, 
find herself compelled to wean it, for she can 
substitute another woman's milk for hers, by 
employing a wet nurse. There is no question 
but that the milk of a good wet nurse is greatly 
to be preferred to artificial feeding in certain 
cases. This is especially true during the heated 
term, and in the wet nurse is often found the 
solution of the problem of saving the baby's 
life; for this reason, it is wise not to wait too 
long before employing the wet nurse. 

The selection of the wet nurse is the duty 
of the physician, and in this selection there are 
certain points to be remembered. First of all, 
the woman applying for this position must be 
carefully examined, in order to ascertain that 
she is free from tubercular or specific taint, en- 



90 BETTER BABIES 

larged glands, any form of skin disease, badly 
decayed teeth, foul breath, and poorly devel- 
oped breasts and nipples. 

The condition of her own baby is often proof 
as to the quantity and quality of her milk, and 
for this reason she should be required to bring 
her baby for inspection to the physician. Often 
women try to evade this, but it is an impor- 
tant point and should not be overlooked. It 
is not necessary to have a woman whose baby 
is the same age as your own; for one to three 
months difference in the ages does not matter. 

One of the gravest mistakes made by mothers 
who employ a wet nurse is, that after she is 
engaged, the over-anxious mother at once be- 
gins to overfeed her, giving her milk, beer, and 
all kinds of food, in the hope that by this means 
the woman will give more milk. The result 
of such a process is that the wet nurse soon 
develops a good case of indigestion, and in a 
few days it is necessary to look for a substi- 
tute, as the first nurse is sick. The proper 
plan is for the mother to ascertain what the 
wet nurse is accustomed to eating, and then 
adhere to that diet, rather than giving the wet 
nurse chicken salad or any other delicacy, be- 
cause the mother herself happens to be fond of 
it. In short, every woman who undertakes to 
act as a wet nurse should lead a perfectly nor- 



BETTER BABIES 9 1 

mal and sanitary life, and should take regular 
exercise in the open air, and have plenty of 
sleep. 



ARTIFICIAL FEEDING OF INFANTS. 

Much as all physicians do deplore the ne- 
cessity for the existence of the bottle fed baby, 
the fact that it does exist, makes the considera- 
tion of artificial feeding a very necessary sub- 
ject. It is, indeed, one of the most perplexing 
problems, to which should be directed the best 
efforts of the chemist, the bacteriologist, veteri- 
narian, dairyman, physician, and the mother. 
While science has made rapid progress in the 
fields of medicine and surgery, this complicated 
and complex subject of artificial feeding of in- 
fants has only, within the very recent past, re- 
ceived either the attention or the enlightenment 
which it merits. Even to-day, it is almost 
amusing, if it were not also tragic, to notice in 
the history of a case of a child artificially fed, 
the varying opinions and experiments which 
the mother has to record. She will often ex- 
claim herself, "How doctors do differ. I have 
already consulted five different physicians with 
this child, and each one prescribes a different 
food." For instance, Dr. B. will say "discon- 
tinue using Dr. A.'s preparation"; while again 



02 BETTER BABIES 

Dr. C. will declare that the child is starving 
under Dr. B.'s care. It is not surprising that 
such a state of affairs will cause the layman to 
look upon the physician with suspicion and sur- 
prise, and yet these very differences of opinion 
are helpful, as they show that each physician is 
endeavoring to reach just the right food for 
the individual baby he is called upon to treat. 
But doctors should not "agree to disagree," un- 
less there is really acute need for it. As a mat- 
ter of fact, society has, in a measure, justified 
the bottle fed baby, by the amount of provision 
and preparation made for it, if we can judge 
from the number of artificial foods on the mar- 
ket; and these, perhaps, more than anything 
else, have been adjuncts in influencing mothers 
NOT to. nurse their babies, because they prefer 
social pleasure gained in the club and ball room 
to the often exacting duty of nursing. It is 
true that many physicians are compelled to di- 
rect a course of artificial feeding for hundreds 
of babies, who could be fed naturally if the 
mothers would so choose, or if, on the other 
hand, they understood the acute necessity for 
so doing. 

I shall not attempt to direct any method of 
artificial feeding in this book, for my main idea 
is rather to prevent the need of such feeding 
than to provide for its use. Then, too, I deem 



BETTER BABIES 93 

it unwise to give any fixed set of milk or food 
formulas, for, as I have said elsewhere, each 
infant is a law unto itself, hence any fixed feed- 
ing rules, given for infants from birth to twelve 
months, would prove actually dangerous to the 
child itself, unless its case be carefully consid- 
ered. I would say here, that if a mother would 
save herself endless regret, she would never 
attempt to prepare her baby's food without the 
advice of a physician. It is mothers who take 
this risk, who form the class I have described 
in the chapter entitled "Had I But Known." 

Differences Between Mother's Milk and 
Cow's Milk. 

But it is well for mothers to know the differ- 
ences between their own milk and that of the 
cow, which is, after all, the best substitute for 
the child who must depend upon artificial feed- 
ing. It is an understanding of these differences, 
and the effort to equalize them, which really 
constitute the bulk of what science has done in 
recent years to solve the problem of artificial 
feeding, and the majority of physicians agree 
with me, in thinking that if the problem is to 
be satisfactorily solved at all, it will be through 
a thorough understanding of how cows' milk 
may be adapted to the use of the human infant. 



94 BETTER BABIES 

The following constitute the chemical differ- 
ences between cows' milk and mothers' milk: 

MOTHERS' MILK COWS' MILK 

Fat 4.0 per cent. 4 per cent. 

Sugar 7.0 per cent. 450 per cent. 

Proteid 1.5 per cent. 3.50 per cent. 

Total Solids ..12.13 per cent. 13.14 per cent. 

Water 87.88 per cent. 86.87 

Reaction Alkaline At First Alkaline 

Bacteria Absent Present 

The foregoing comparison will show that 
the fats are the same in proportion in both 
milks, but there is a vast difference in the fatty 
acids of cows' milk, and there is a difference 
in the digestion of fats from different herds 
of cows, the Holstein being the best. Then, 
there is nearly twice as much sugar in mothers' 
milk as in cows' milk, and the same can be said 
of the proteids. Therefore, to have a well- 
balanced ration for an infant, these ingredients 
must always be in proper proportion, in order 
to be readily assimilated. 

Wachenheim, of New York, says, "the pro- 
teid of cows' milk contains no lecithin and no 
phosphorus, both of which are essential elements 
in human brain tissue. Neither cows nor their 
calves need this lecithin or this phosphorus. 
Their program of existence does not call for 
thinking, and the milk supplied to them is suffi- 
cient for rumination and for their simple bucolic 



BETTER BABIES 95 

needs. Mothers' milk, on the other hand, does 
contain both lecithin and phosphorus, which are 
essential elements in her baby's development." 
As I have explained elsewhere, it takes a baby 
two years to attain its full brain development, 
although not, of course, its full mental growth, 
while the calf has all the brains it needs at 
birth. 

Another marked difference in mothers' milk 
and cows' milk, is that the casein of mothers' 
milk is precipitated in fine light flocules, which 
are easily digested, while the casein of cows' 
milk is precipitated in large, tough curds, not 
so easily digested, although our present knowl- 
edge of this element enables us to aid this dif- 
ference of digestibility. 

While mothers' milk is absolutely free of bac- 
teria, we know that cows' milk is laden with 
them, and these bacteria are a source of the 
greatest danger. On this subject, volumes 
could be written, but I must content myself with 
telling you that it has taken the combined efforts 
of the national, state, and local laws to gov- 
ern the production, distribution, and sale of 
cows' milk which is fit to enter a baby's stomach. 
If half the time and money were spent in edu- 
cating, housing, clothing, and feeding the aver- 
age mother, and then inducing her to produce 
good, sterile milk, it would remove the neces- 



gS BETTER BABIES 

sity of spending several million dollars yearly 
to make cows' milk fit for daily consumption. 

But it must be admitted that much credit 
should be given to the chemist and bacteriolo- 
gist, who make milk analyses, and who then tell 
us whether it is suitable for the baby's use. In 
addition, we must give credit also to the dairy- 
man, who has learned how to keep himself, his 
barns, his cows, all his utensils, and his milkers 
absolutely sterile, or as far so as is possible, and 
we must also thank the physician who directs 
the food formulas for individual infants. The 
careful physician will even go so far as to mix 
the milk the first time, himself, in order to be 
sure the mother or capable nurse understands 
exactly how this is to be done. As I have said 
before, the mother or nurse should be careful 
to see to it that milk is NEVER left standing 
in the sun, but that it is carefully placed in a 
clean refrigerator, next to a large block of ice. 
In preparing baby's milk, the mother should 
take all sanitary precautions; she should wash 
her own hands carefully with good soap before 
handling the milk, and she should use only the 
BEST milk at all times. By the best milk I 
mean certified milk, which is produced under the 
direction of a Milk Commission, appointed by 
the president of a county Medical Society. 



better babies 97 

The Value of a Milk Commission. 

Too much stress can not be laid on the work 
done by Milk Commissions, to procure good, 
clean, wholesome milk for our people. The 
thanks of the entire country should be tendered 
to Dr. C. L. Coit, of Newark, N. J., who organ- 
ized the first Milk Commission in the country. 
This Milk Commission adopted certain rules 
and regulations, and these, from time to time, 
have been made more comprehensive and more 
rigid, as the occasions seemed to warrant. At 
first, about 30,000 bacteria to the C. C. (about 
20 drops) were allowed; now 10,000 bacteria is 
the maximum number. All dairymen who reach 
the requirements of the Milk Commissions are 
allowed to have the caps on the bottles they use 
stamped with the words : "Certified by the Milk 
Commission" (using the name of his own Milk 
Commission) , together with the date. Certified 
milk must contain not less than 4 per cent, but- 
ter fats, and must possess all the other charac- 
teristics of pure, wholesome milk. 

The Milk Commissions have established rigid 
rules for the producer as to the care of the 
barn yard, the stable, the water supply, the 
cows, the milkers, the helpers, other than milk- 
ers, and, in fact, all of the surroundings where 
milk is produced. Cats and dogs are prohibited 



98 BETTER BABIES 

from running around the barnyard and stable, 
and every possible avenue, from which con- 
tamination might emanate, is prohibited. Spe- 
cial supervision is required in the straining, cool- 
ing, bottling, etc., while the caps, bottles, pails, 
must be kept in sanitary places and be thor- 
oughly clean and sterile. 

The bacteriologist of the Milk Commission 
is required to collect milk at different times, ex- 
amine it thoroughly, and report to the Commis- 
sion. The cows are examined twice yearly by 
an expert veterinarian, for tuberculosis, and 
every possible safeguard is thrown around the 
production of certified milk, and while its price 
is, perhaps, beyond the reach of all poor citi- 
zens, still we have, in almost every large city, 
a number of reliable dairies producing good, 
clean milk. In Atlanta, I know there are at 
least twenty dairies who could easily certify, as 
their bacterial count made by the local Board 
of Health, is 10,000 and under. 

It must be remembered that not all bacteria 
are harmful, for in the souring of milk, lactic 
acid bacteria are present in quite large quanti- 
ties; but bacteria of decomposition, under con- 
ditions favorable to their growth, attack the 
proteid constituents of the milk, producing pu- 
trefactive changes, which, with the evolution of 
certain poisons, may be destructive of life. Milk 



BETTER BABIES 99 

is a most excellent culture field for bacteria, and 
when there is contamination from unclean ud- 
ders, flies, improper refrigeration, etc., it is 
only to be expected that there will result a tre- 
mendous death rate, especially during the heated 
term. 

Whether to Pasteurize or Sterilize. 

Whether to pasteurize or sterilize milk will 
depend on the quality of the milk, and on cer- 
tain local conditions, which must be left to the 
physician to determine. But in preparing the 
milk directly for the baby's use, the mother must 
observe as careful rules as those laid down for 
the dairyman. After the baby has used a bot- 
tle, it should immediately be cleaned, and not 
allowed to stand a minute with the possible dan- 
ger of contamination by flies. The bottle should 
have a neck wide enough to permit of its being 
easily washed with soap and water, then with 
borax water, and a stiff brush with which to 
scrub out the inside. The nipples should be 
turned inside out and washed in borax or soda 
water, two or three teaspoonsful to a pint of 
hot water being the proportion. Then the nip- 
ples should be left in a saturated solution of 
boric acid, to which a little soda has been added, 
until the next feeding, when they should be 
rinsed off with sterile water just before using. 



IOO BETTER BABIES 

In not a few difficult feeding cases, we often 
use peptonized milk, whey, malt-soup, condensed 
milk, evaporated cream, and, in some instances, 
where there seems no chance of making milk in 
any form tolerated, we must resort to the wet 
nurse. 

In looking over the number of proprietary 
foods on the market, I find about as many as 
Heinz's Pickles. A few, perhaps, of the "fifty- 
seven varieties," are good temporary foods. 
The majority of these claim that they render 
the casein more digestible, by making the curds 
in a softer mass. However, those foods not 
mixed with cows' milk, do not seem to have all 
the nutritional value necessary to produce the 
perfect baby. 

The collective investigation of the American 
Pediatric Society states that the proprietary 
foods cause the greater number of cases of 
scurvy; and this is also true of condensed milk, 
and of sterilized milk. Therefore, if sterilized 
milk is given for any length of time, it is well 
to give two or three teaspoonsful of orange 
juice daily. Orange juice seems to replace that 
something which, in heated milk, is lost, and 
which, by its absence, produces scurvy. 

The diseases, born of impure milk, are tuber- 
culosis, typhoid fever, scarlet fever, and septic 
sore throat; hence it is well to guard all milk, 



BETTER BABIES 101 

whether for use of the adult or infant. There 
can be no greater work for women's clubs, civic 
organizations, of all kinds, municipal health 
boards, physicians, and all classes of citizens, 
than that of regulating the milk supply of the 
community. By this regulation, infant mortal- 
ity may be greatly reduced and the public health 
conserved and improved. 

For special works on infant feeding, I would 
especially refer the reader to those by Morse 
& Talbot, Wachenheim, Dennett, Chapin & 
Pisek, Kerley and Holt. 



DIET FROM THE FIRST TO THE 
SIXTH YEAR. 

No mother's duty to her young child ever 
ceases; the duty she owes it during the months 
when it is a part of her own being, the duty she 
owes it during the first year of its life, and the 
duty she owes it through all its future, is an 
ever-present obligation, and to the thoughtful 
mother a most sacred one. I feel, therefore, 
that my own duty to my readers will not be ful- 
filled unless I can give to mothers some guidance 
for feeding the children who may come to her, 
during those years which follow the time when 
she is able and willing to nourish it herself. The 



102 BETTER BABIES 

subject, however, of the diet from the first year 
to the sixth year is, fortunately, one upon which 
most authorities agree, and for this reason I 
have not attempted to make any new sugges- 
tions on this line, but will, instead, quote ex- 
actly Dr. Charles Gilmore Kerley, who, in his 
most valuable book entitled "The Practice of 
Pediatrics," has given the following careful, ac- 
curate, comprehensive and perfectly practical in- 
structions on this subject. He says: 

"At the completion of the twelfth month the 
average well-regulated infant should be weaned 
and given other nourishment. If bottle fed he 
should receive more than the milk and cereals, 
with which most children are fed. The food 
suitable for the second year of life, and the 
method of its preparation and administration 
are subjects concerning which the masses are 
profoundly ignorant. A few children at this 
period of life are underfed, but the great ma- 
jority are overfed and carelessly given, at im- 
proper intervals, unsuitable food, indifferently 
prepared. Summer diarrhea finds its greatest 
number of victims among those children over 
twelve months of age who have been carelessly 
fed. 

The Second Summer. 

"The dreaded 'second summer' robs many 
homes because of ignorant or careless parents. 



BETTER BABIES 103 

The second summer, approached properly, is 
hardly more dangerous than any other summer 
during the early years of a child's life. It is 
almost a universal custom, when the child is 
weaned or given something other than a milk 
diet, to allow him 'tastes' from the table. Very 
often these tastes comprise the entire dietary 
of the adult. Milk is oftentimes the only suit- 
able article of diet that is given. Eventually, 
not only is the other food selected unsuitable, 
but it is given irregularly, and supplemented by 
crackers kept on hand for use between meals. 
During the hot months the gastro-intestinal tract 
is less able to bear such abuse and the child be- 
comes ill. 

Feeding After the First Year. 

"Usually when the twelfth month is com- 
pleted, I give the mother a diet schedule, with 
instructions to begin gradually with the articles 
allowed, in order to test the child's ability to 
digest them. Every new article of food should 
be carefully prepared and given at first in very 
small quantities. All meals are to be given regu- 
larly, with nothing between meals. With many 
children, this expansion of the diet-list is at- 
tended with considerable difficulty. They are 
thoroughly satisfied with milk, and refuse all 
other forms of nourishment. In such cases, 



104 BETTER BABIES 

time and patience are necessary at feeding time. 
The more solid articles of diet should be given 
first and the milk kept in the background. 

"Among the underfed seen at this period of 
life are those who were nursed too long, or 
those who were kept too long upon an exclusive 
milk diet. A great majority of the cases of 
malnutrition of the second year are seen in the 
exclusively milk fed. These children are pale, 
soft, flabby, and badly nourished. 

"The following is a diet schedule which I 
have employed for several years. Each mother 
is instructed to select, from the foods allowed, 
a suitable meal: 

"From the twelfth to the fifteenth month; 
five meals daily: 

"7 a. m. — Oatmeal, barley or wheat jelly, 
one to two tablespoonfuls in 8 ounces of milk. 
(The jelly is made by cooking the cereal for 
three hours the day before it is wanted, and 
straining through a colander.) Stale bread and 
butter, or zwieback and butter. 

"9 a. m. — The juice of one orange. 

"11 a. m. — Scraped rare beef, one to three 
teaspoonfuls, mixed with an equal quantity of 
bread, and moistened with beef-juice. Or a 
soft-boiled egg mixed with stale bread-crumbs; 
a piece of zwieback and a half-pint of milk. 
(Scraped beef is best obtained from round 



BETTER BABIES 105 

steak, cut thick and broiled over a brisk fire, 
sufficiently to sear the outside. The steak is 
then split with a sharp knife, and the pulp 
scraped from the fiber.) 

"3 p. m. — Beef, chicken, or mutton broth, 
with rice or stale bread broken into the broth. 
Six ounces of milk, if wanted. Stale bread and 
butter or zwieback and butter. Many children 
at the above age will take and digest apple- 
sauce and prune pulp; when these are given, 
milk should be omitted. 

"6 p. m. — Two tablespoonfuls of cereal jelly 
in 8 ounces of milk; a piece of zwieback. Stale 
bread and butter or Huntley and Palmer break- 
fast biscuit. 

"io p. m. — A tablespoonful of cereal jelly 
in 8 ounces of milk. 

"From the fifteenth to the eighteenth month; 
four meals daily: 

"7 a. m. — Oatmeal, hominy, cornmeal, each 
cooked three hours the day before they are used. 
When the cooking is completed, the cereal 
should be of the consistence of a thin paste. 
This is strained through a colander, which upon 
cooling will form a mass of jelly-like consist- 
ence. Of this, give two or three tablespoon- 
fuls, served with milk and sugar, or butter and 
sugar, or butter and salt. Eight to ten ounces 
of milk as a drink. Zwieback or toast. 



106 BETTER BABIES 

"9 a. m. — The juice of one orange. 

"11 a. m. — A soft-boiled egg, mixed with 
stale bread crumbs, or one tablespoonful of 
scraped beef, mixed with stale bread-crumbs and 
moistened with beef-juice. A drink of milk. 
Zwieback or bran biscuit, or stale bread and 
butter. 

"3 p. m. — Mutton, chicken, or beef broth, 
with rice or with stale bread broken in the 
broth. Custard, corn-starch, plain rice-pudding, 
junket, stewed prunes, baked apple or apple- 
sauce. 

"6 p. m. — Farina, cream of wheat, wheatena 
(cooked two hours). Give from one to three 
tablespoonfuls, served with milk and sugar, or 
butter and sugar, or salt and butter. Drink of 
milk. Zwieback or stale bread and butter. 

"From the eighteenth to the twenty-fourth 
month; four meals daily: 

"7 a. m. — Cornmeal, oatmeal, hominy (pre- 
pared as in the above schedule). Serve with 
butter and sugar, or milk and sugar, or butter 
and salt. A soft-boiled egg every two or three 
days. Hashed chicken on toast occasionally. 
A drink of milk. Bran biscuit and butter or 
stale bread and butter. 

"9 a. m. — The juice of one orange. 

"11 a. m. — Rare beef, minced or scraped; 
the heart of a lamb chop, finely cut. Chicken. 



BETTER BABIES IO7 

Spinach, asparagus tips, squash, strained stewed 
tomatoes, stewed carrots, mashed cauliflower. 
Baked apple or apple-sauce. Stale bread and 
butter. 

"After the twenty-first month baked potatoes 
and well-cooked stringbeans may be given. 

"3 p. m. — Chicken, beef, or mutton broth, 
with rice or with stale bread broken into the 
broth. Custard, corn-starch, or plain rice-pud- 
ding, junket, stewed prunes. Bran biscuit and 
butter, or stale bread and butter. 

"6 p. m. — Farina, cream of wheat, wheatena 
(each cooked two hours). Give from one to 
three tablespoonfuls, served with milk and 
sugar, or butter and sugar, or butter and salt. 
Drink of milk. Zwieback or stale bread and 
butter. 

"After the eighteenth month a large number 
of children will have a better appetite and thrive 
more satisfactorily on three full meals a day. 
The breakfast is advised at 7 130 a. m. and the 
dinner at 12 o'clock. At three p. m., or three- 
thirty p. m., a cup of broth and a cracker or 
toast and a drink of milk may be given. 

"From the second to the third year; three 
meals daily: Breakfast: 7 to 8 o'clock. Oat- 
meal, hominy, cracked wheat (each cooked 
three hours the day before they are used), 
served with milk and sugar or butter and sugar. 



I08 BETTER BABIES 

A soft-boiled egg, hashed chicken. Stale bread 
and butter. Bran biscuit and butter, a drink of 
milk. 

"At 10 o'clock the juice of one orange may 
be given. Dinner: 12 o'clock. Strained soups 
and broths, rare beefsteak, rare roast beef, poul- 
try, fish. Baked potato, peas, string beans, 
squash, mashed cauliflower, mashed peas, 
strained stewed tomatoes, stewed carrots, spin- 
ach, asparagus tips. Bread and butter. For des- 
sert: Plain rice pudding, plain bread pudding, 
stewed prunes, baked or stewed apple, junket, 
custard, or cornstarch. 

"Supper: 5 130 to 6 o'clock. Farina, cream of 
wheat, wheatena (each cooked two hours). 
Give from one to three tablespoonfuls served 
with milk and sugar, or butter and sugar, or 
butter and salt. Drink of milk. Zwieback or 
stale bread and butter. Twice a week custard, 
cornstarch, or junket may be given, or a table- 
spoonful of plain vanilla ice cream. 

"As a rule, three meals answer best at this 
period. With three meals a child has a better 
appetite and much better digestion, and conse- 
quently thrives far better than one whose stom- 
ach is kept constantly at work. Some children, 
however, will require a luncheon at 3 or 3 130 
p. m., and will not do well without it. This is 
apt to be the case with delicate children, par- 



BETTER BABIES IO9 

ticularly those under two and one-half years of 
age. If food is necessary at this hour, a glass 
of milk and a graham biscuit or a cup of broth 
and zwieback will answer every purpose. In- 
stead of the afternoon meal, the child may rel- 
ish a scraped raw apple or a pear. Fruit at this 
time is particularly to be advised if there is 
constipation. Children recovering from serious 
illness will require more frequent feeding. 

"From the third to the sixth year: 

"Breakfast: Cracked wheat, cornmeal, hom- 
iny, oatmeal (each cooked three hours the day 
before they are used). These may be served 
with milk and sugar, or butter and sugar, or 
butter and salt. A soft-boiled egg, omelet, 
scrambled egg. Bread and butter, bran biscuit 
and butter. A glass of milk. 

"Dinner: Plain soups, rare roast beef, rare 
beefsteak, poultry, fish, potatoes stewed with 
milk or baked. Peas, string beans, tomatoes 
(strained, stewed), stewed carrots, squash, 
boiled onions, spinach, mashed cauliflower, as- 
paragus tips, bread and butter. For dessert: 
Rice pudding, plain bread pudding, custard, 
tapioca pudding, stewed prunes, stewed apples, 
baked apples, raw apples, pears, and cherries. 

"Supper: Farina, cream of wheat, wheatena 
(each cooked two hours). Give from two to 
three tablespoonfuls, served with milk and 



110 BETTER BABIES 

sugar, or butter and sugar, or butter and salt. 
Zwieback or stale bread and butter. Bread and 
milk. Milk-toast. Scrambled eggs twice a 
week. Custard or cornstarch each, once a week, 
ice cream once a week. Bread and butter. A 
glass of milk. 

"When the child has eggs for breakfast, they 
should not be repeated in any form for supper. 
Red meat should be given but three times a 
week. When the child has a chop for break- 
fast, he should have poultry or fish for dinner. 
At this age of great activity and rapid growth, 
the child will often demand food between din- 
ner and supper. Carefully selected fruit, such 
as an apple, a pear, or a peach, may be given at 
this time, supplemented by a graham cracker 
or two, or by stale bread and butter, if it is 
found that their use does not interfere with their 
evening meal." 



FRESH AIR AND SUNLIGHT. 

It is a remarkable fact that physicians often 
fail to consider the remedial agencies for dis- 
ease, especially for those of childhood, which 
are contained in Nature's own remedies, fresh 
air and sunshine. No agriculturist or horticul- 
turist, no stock breeder or veterinarian would 



BETTER BABIES III 

ever fail to recognize the value to the plant and 
animal life of both these agencies, and yet it 
is a fact that for many years medical science 
has either overlooked altogether, or failed to 
understand, just what element of strength could 
be imparted to the human organism by judi- 
cious exposure to naturally generated light and 
heat. 

Within the comparatively recent past, and 
clearly within the experience of many physicians 
living and working to-day, the erroneous fear 
of fresh air in a sick room was a vital force 
to be combated in the minds and habits of 
the mother and nurse. The idea of exposing 
little children to outdoor air seemed curiously 
repugnant even to many otherwise intelligent 
parents, but it is interesting to note a steady and 
growing change in this attitude. Of course, 
like all fallacies, when once disproven, there 
was naturally a rebound of the pendulum, and 
when physicians had once discovered that fresh 
air was really a helpful agency in the treatment 
of all respiratory disease, such diseases were sub- 
jected to cold air, moisture laden air and all 
sorts of undesirable air, on the assumption that 
it was "fresh air" and therefore GOOD for 
the patient. From such a condition there re- 
sulted actual harm in many cases, yet it was the 
harm of the reformed who advanced too rap- 



112 BETTER BABIES 

idly. To-day we have reached a better under- 
standing of the value of fresh air, cold air, and 
applied sunshine, and it is gratifying to note a 
most valuable article by John Lovett Morse 
M.D., contributed to the Journal of the Ameri 
can Medical Association of January 8, 19 16 
This article is entitled "The Treatment of Res 
piratory Diseases in Infancy and Childhood 
with Special Reference to the Value of Fresh 
Air." I am tempted to quote the article in full 
as few laymen ever have the opportunity to read 
the Journal referred to, but space forbids more 
than the following excerpts. Dr. Morse says, 
in part: 

"It is self-evident that if we feel better in 
fresh air than in close air, fresh air is better 
than close air for the sick, whether or not we 
are suffering from diseases of the respiratory 
tract. It is also evident that air which is free 
from dust is more suitable in these conditions 
than air which is full of dust. It is also evident 
that improper ventilation increases the dangers 
of reinfection from the patient and of infection 
from other patients or attendants. Coolness is 
one of the essential elements of fresh air. Cool 
air is not, however, cold air. Very little is 
known accurately of the action of cold air on 
the respiratory mucous membrane. Clinical 
experience shows, however, that when the mu- 



BETTER BABIES II3 

cous membrane of the respiratory tract is acute- 
ly inflamed, as in the early stages of naso-pharyn- 
gitis, laryngitis, or bronchitis, cold air acts as 
an irritant, increasing the cough and symptoms 
of heat and tightness of the chest. Clinical ex- 
perience shows also that in naso-pharyngitis 
after the acute stage is passed and the mucous 
membrane is swollen, cold air relieves conges- 
tion and diminishes discomfort. Cold air can 
not, under ordinary conditions, have any action 
on the mucous membrane of the respiratory tract 
below the trachea or largest bronchi, because it 
will be warmed before it reaches it. 

"Howland and Hoobler (authorities on this 
subject) have found that in pneumonia in chil- 
dren the exposure of the face of the children to 
cold air produces a rise in the blood pressure. 
They also found that when children were out- 
of-doors in warm weather the blood pressure 
was not raised. They concluded, therefore, that 
the all important factor in raising the blood 
pressure was the temperature of the air (not 
its freshness). 

"It is evident that the elements of freshness 
and coldness in the air must be considered sep- 
arately. Experience proves that fresh air is of 
advantage. Children with acute naso-pharyn- 
gitis should be kept in the house in cold weather, 
in well-ventilated rooms, at a temperature of 



114 BETTER BABIES 

about 60 degrees F. if they are in bed, and from 
65 to 70 degrees if they are out of bed." Dr. 
Morse explains at some length, and with de- 
tailed accounts of cases, that he does not advo- 
cate the wholesale use of cold air in the treat- 
ment of any of the diseases of the respiratory 
tract. He has sounded the note of warning 
which the medical profession has needed, and 
which the laymen would do well to hear. Dr. 
Morse concludes that "Fresh air is of advan- 
tage in the treatment of all diseases of the res- 
piratory tract. It is also of advantage to have 
the air pure; that is, free from bacteria, dust, 
and smoke. Cold air is of advantage in some 
conditions, but harmful in others. It must be 
used with discretion. It is not possible to 
treat all diseases of the respiratory tract in the 
same way." 

Perhaps the latter sentence is the keynote of 
the whole situation, and certain it is that the 
modern physician would do well to avoid "glit- 
tering generalities," and to confine himself to 
conservative, careful, and cautious consideration 
of individual cases, and that by so doing, he will 
meet with the greatest percentage of success. 

Sunlight. 

As I have said at the beginning of this chap- 
ter, we have not yet taken into consideration the 



BETTER BABIES 115 

therapeutic value of sunshine. Dr. J. W. Kime, 
in the New York Medical Record of February 
12, 19 1 6, has given this subject a wonderful 
impetus. Dr. Kime says : 

"There are few lessons so difficult to learn 
as the lesson of sunlight. The chapter on fresh 
air is beginning to be understood — only begin- 
ning, however, for thousands of windows still 
are tightly closed both day and night which 
should be widely opened for the admission of 
the fresh pure air from without. But that 
light, sunlight, is of the greatest value in the 
maintenance of health, and even of life, is com- 
prehended by but few, indeed by almost none at 
all. Even physicians do not know, or, know- 
ing, fail to heed the necessity for the admission 
of sunlight to their homes. 

"In consequence, we find in every city and in 
every rural district splendid homes which are 
swamped in trees — swamped to such an extent 
that even the grass refuses to grow; the win- 
dows are small and few in number, and even 
upon these, the shades are pulled far down to 
exclude the light. These homes are dark and 
often are damp — the very conditions most 
favorable to bacterial growth. In homes like 
these ill health must be the rule. 

"In the plant world, light is essential for 
health and growth. If growth within the house, 



Il6 BETTER BABIES 

the shoots are weak and pale and spindling, 
while just without, where the sunshine falls, the 
same plants are strong and rugged and clothed 
in green. 

"In dark places, in caves and cellars where but 
few straggling rays of light may enter, plant life 
is devoid of health and strength and color; the 
energy imparted by sunlight is wholly lacking; 
the rich green chlorophyl which only the sun- 
light paints in grass and leaf and flower is not 
imparted in caves and gloomy places where sun- 
light never falls. 

"The familiar and homely potato proclaims an 
eloquent lesson of the beneficent powers of sun- 
light. We store this vegetable in places that 
are dark and close; a dingy window in the base- 
ment wall admits a fraction of light. Along 
toward springtime the 'eyes' begin to swell 
and soon long, white, fragile sprouts emerge 
and creep long distances upon the dark cold 
floor. These 'sprouts' are identical with the 
tough green stalks in the open garden, upon 
whose rootlets these useful tubers grow. 

"In plant life, sunlight measures the distance 
between life and death. 

"The human type confined indoors is pale and 
weak and bloodless. If blood there be, it is but 
tinged with red; the deep red colors which only 



BETTER BABIES 117 

the sunlight paints are reserved for those who 
live outdoors. 

"It therefore comes about in the course of 
time, and of human events, that, every fourth 
generation, we must go back to the rural dwell- 
ers for a new influx into urban life. Indeed, 
were it not for this steady stream continuously 
flowing from rural to urban districts, our city 
life would soon lose much of its virile power. 

"City life is life within doors — in shops and 
factory, in office and counting room, in homes, 
too often, from which sunlight is removed; it 
is life in which the blood runs pale. It is close 
akin to the life which creeps and crawls on the 
dark damp floor beneath the house. 

"There once was a race of human dwellers 
that lived in caves. They burrowed beneath the 
ground, they scaled great cliffs and dug into 
their walls. From out their homes the light of 
day was wholly shut — and of the cliff dwellers 
only these caverns now remain. 

"The dwellers in cities, and too often those in 
the country, approach in a measure, in their 
habitations, the darkened homes of these for- 
gotten peoples. Their homes are dark, the sun- 
light is excluded, the houses are swamped in 
trees. The conditions are those too nearly re- 
lated to life within the cave. 



Il8 BETTER BABIES 

"Light is an energy of wondrous power. 
Great trees bend and grow toward it. Light 
paints the color of every flower and tinges the 
cheek with the glow of health. Without light, 
the world would be dead and the firmament be 
blotted out. In darkness, it is not possible for 
man to live. Reason fails, the health breaks, 
and death soon comes. 

"De Laroquette has observed that 'the human 
body, like the plant, draws from the sun an im- 
portant part of the energy necessary for the 
maintenance of life.' In other words, the food 
we eat and the air we breathe do not alone sup- 
ply all that is necessary for our existence. The 
radiant energy of the sun is equally necessary 
to life. We are constantly receiving and ab- 
sorbing into our bodies light waves either from 
the direct rays of the sun or from the diffused 
light about us. These light rays perform an 
important function in maintaining the body 
health. Indeed, the cell life of the animal tis- 
sues can no more be continued in the dark than 
can the cell life of the plant when light is ex- 
cluded from it. And yet the physiology of light 
has scarce been touched upon. 

"Sunlight, either direct or diffused, when fall- 
ing upon our bodies is in part absorbed and in 
part is reflected from their surfaces. The dark- 
er the skin the more absorption takes place. In 



BETTER BABIES II9 

the African, practically one hundred per cent, of 
the sun's rays falling upon his body is absorbed, 
while in the case of the blond a large percentage 
is reflected. The amount of light energy which 
reaches the clothed body is not great, as prac- 
tically all the rays are absorbed by the clothing 
worn. Hence, merely sitting or walking about 
in the sunshine falls far short of what is meant 
when we speak of 'light treatment' or 'helio- 
therapy.' 

"The sunlight absorbed by the body repre- 
sents a tremendous energy which becomes a part 
of the vital assets of the individual. Much of the 
light energy is taken up by the blood and is 
carried by it to every organ within the body. 
Many years of experience by numerous investi- 
gators have shown that this energy is not only a 
real power for good in the maintenance of 
health but is applicable to the treatment of a 
wide range of diseases. Indeed, it was well 
known to physicians of the earlier centuries that 
sunlight was one of the most efficient remedies 
at their command. It was in general use as a 
therapeutic agent in that day and solaria were 
built into the homes of many of the wealthy peo- 
ple. Among some primitive peoples, as in sec- 
tions of South America, sunlight is still used in 
much the same way it was centuries ago. 



120 BETTER BABIES 

"But sunlight as a remedial agent was for hun- 
dreds of years almost wholly abandoned by the 
medical profession and it has been only during 
the last decade that attention has again been 
directed to it. Sufficient data are now at hand 
to enable us to make a partial list of the affec- 
tions to which sunlight may profitably be ap- 
plied. 

"The most noticeable results, perhaps, have 
been obtained in the treatment of rachitic chil- 
dren and of children suffering from various 
forms of bone tuberculosis. Rollier, of Switzer- 
land, most notably, has obtained marvelous re- 
sults in this class of patients. He exposes the 
entire body surface of these children to the sun- 
light for several hours each day. Almost with- 
out exception they at once begin to take on 
weight and to gain in strength and soon are 
well on their way to complete recovery. 

"In anemia, very similar results are obtained. 
Many of these patients have been closely housed, 
often in homes that are dark, their nutrition is 
bad, they are in need of just such an invigor- 
ating tonic as sunlight proves to be. Their blood 
is lacking in hemoglobin and this the light pro- 
duces just as in the plant cell the sunlight brings 
the bright green chlorophyl. 

"For like reasons sunlight proves the remedy 
par excellence in diseases of debilitating nature, 



BETTER BABIES 121 

in tuberculosis and other wasting diseases, in 
neurasthenia, and in convalescence from disease. 
Such patients properly exposed to the direct rays 
of the sun usually respond most favorably to 
the treatment. 

"In skin affections sunlight promises brilliant 
results. As many of these diseases are of bac- 
terial origin the explanation is not far to seek. 
Sunlight is the most efficient bactericide known; 
the light kills the bacteria and the skin heals by 
natural processes. In lupus, eczema, psoriasis, 
and other skin lesions of bacterial origin, re- 
sults are both prompt and gratifying. 

"Heliotherapy is the treatment of disease by 
means of sunlight falling directly upon the nude 
body of the patient, and by the use of sunlight 
concentrated by means of convex lenses or by 
concave reflectors and directed upon certain lo- 
cal areas of the body which may be in need of 
treatment. 

"Sitting or walking in the sunshine with the 
body fully clad may be of a little value, but it 
is not heliotherapy. In the treatment of disease 
by sunlight not even the thinnest clothing is 
permitted to intervene, as the clothing absorbs 
the sun's rays and the full effect of the light is 
not obtained. Whenever possible, the entire 
body is exposed to the sunlight, the head only 
being protected from it. 



122 BETTER BABIES 

"The patient must very gradually become ac- 
customed to the sunlight, otherwise disagreeable 
burns may be produced and blistering may oc- 
cur. The usual method in initiating the patient 
to treatment is by the exposure of the feet and 
legs to the light for ten or fifteen minutes on 
the first day; on the second day, the feet, legs, 
and thighs are exposed for fifteen minutes; on 
the third day, the lower portion of the body is 
added, and on the following day the entire body, 
with the exception of the head, is exposed for 
the same length of time. The daily treatments 
are now gradually increased in length until an 
hour or more is passed with the full body ex- 
posed to the light. In winter the patient must 
thus lie in the sunshine for a number of hours 
each day. 

"No matter what form of malady for which 
treatment is given the exposure of the body is 
total; in this manner only may all the blood cir- 
culating on the surface of the body be flooded 
with the sunlight. 

"The revival of the 'sun cure,' added as it 
now is to the discoveries made during the past 
quarter of a century in the field of bacteriology, 
means much to the relief of many diseases 
whose causes are of bacterial origin." 

The foregoing article marks the first step in 
the acceptance of the curative value of sunlight 



BETTER BABIES I 23 

by the medical profession, and as the treatment 
may prove invaluable in treating many of the 
diseases of childhood, I have given it this much 
space. I would in addition, again mention here 
the recently accepted value of sunlight as a disin- 
fectant, to which I have referred more fully in 
the Chapter on Contagious Diseases. 



HISTORY OF CASES IMPORTANT. 

All mothers should understand the impor- 
tance of watching the illnesses of their children. 
Disease is like a fire; if discovered in its in- 
cipiency, it can easily be checked and soon con- 
trolled, but if left unrecognized, it soon be- 
comes a devastating flame which wipes out all 
that is in its path. It is one of the most solemn 
obligations of a parent to become familiar with 
the symptoms of disease and, if she will, to try 
a few simple home remedies to check the ill. 
But every mother should remember that often 
it is the truest economy to send for a doctor AT 
ONCE; in many instances, a few visits, at the 
very beginning of a disease, will save many 
visits paid, if the "watchful waiting" policy is 
pursued. 

In young children the only evidence of illness 
is what we call a "droopy" appearance; the 



124 BETTER BABIES 

child refuses to take notice, if it is old enough 
to do so, but if it is even younger than the 
noticing age, illness is evidenced by a restless- 
ness and fretfulness, a feeling of undue warmth 
and dryness of the skin, and this condition will 
soon be found to accompany irregular and badly 
colored stools, especially during the heated term. 
The physician is not omniscient; he must be 
helped in order to understand the nature, extent, 
and progress of a child's sickness. He can not 
do this without a careful history of the attack 
from the mother herself. It often means a good 
deal to a doctor, and even more to the patient, 
to be able to learn a full, clear and comprehen- 
sive history of a case. For instance, if a physi- 
cian is called in to attend a case of summer 
complaint or summer diarrhea in a child, the 
first question he asks is: "How long has this 
been going on;" the intelligent mother will re- 
member the exact day when baby's bowels first 
began to appear abnormal; she will even have 
taken the precaution to have saved the last nap- 
kin for the doctor to see; she will be able to 
say just what remedies she has herself tried, 
what symptoms of discomfort the baby shows, 
what its temperature is and similar details. The 
doctor will then be in a position to give the case 
intelligent attention. He knows from this his- 
tory just how long the disease has been in prog- 



BETTER BABIES 1 25 

ress, and from the other details given he will be 
able to prescribe for the child correctly. 

Importance of Diet. 

Perhaps no other one item is quite as impor- 
tant in diagnosis of disease and also its treat- 
ment as the diet. The past diet of a child should 
always be given accurately to a doctor; from 
this accuracy he will be able to tell whether the 
child is suffering from a case of indigestion, or 
from some more obscure stomach or bowel trou- 
ble. Mothers should learn this fact and never 
forget it. TELL THE DOCTOR THE 
TRUTH ABOUT WHAT BABY EATS; he 
MUST know if he is to help it. Recently a 
poor woman came into my office; she was one 
of a colony of indigent Russians, and could 
barely speak English; she held a sadly emaciated 
specimen of babyhood in her arms and handed 
it to me with the words, "Baby seek;" I could 
easily see she was right; the baby was sick. 
"What is the matter with the baby?" I asked; 
"Teet and bowels," she answered. "How long 
has it been like this?" I asked; "Oh," she re- 
plied, "ten, maybe fifteen days." On being asked 
what she gave it to eat, she answered: "Jist 
soup and tea." "Nothing else?" I demanded. 
"Oh, well a little cracker, maybe," she replied. I 
knew, of course, there must be some other in- 



I2 6 BETTER BABIES 

discretion in diet, and on pressing the woman 
for an answer, I finally elicited, "Veil, it ketches 
from the table!" Of course, this meant every- 
thing, as the poor little atom of humanity was 
really ten months old, although it did not look 
more than five or six, but it was evidently put 
to the table in a high chair, and was thus able 
to "ketch" considerable food, which was acting 
as a poison to the poor little thing. The re- 
covery of this child, as that of hundreds of oth- 
ers, depended upon the care which the poor 
ignorant mother could be taught to give its diet. 
While this case may be said to be extreme, it is, 
nevertheless, the type of a class. 

Unwise Dosing. 

But there is another class of mothers who are 
just as great a trial to a physician as those who 
deny, conceal, or fail to understand, the im- 
portance of diet. I refer to that class who are 
accustomed to giving their babies all sorts of 
medicine at the suggestion of friends, neighbors, 
or relatives. A recent case came to me of a 
baby really very ill with stomach trouble; I ask- 
ed at once what the child had had in the way 
of food and medicine. The mother who seemed 
to be fairly intelligent replied: "I gave it a 
good dose of castor oil, but I gave some calomel 
first; it made the baby pretty sick, too." 



BETTER BABIES I 27 

"Anything else?" I asked. 

"Well, I wrote to Maw, she lives in South 
Georgia, and she came right down; she brought 
some fine blackberry wine ; it did me lots of good 
last year and she gave the baby some; it is fine 
you know for loose bowels. And, Maw, she 
had ten children; she raised three of them, too !" 

"Anything else been given the baby?" I per- 
sisted. 

"Nothing but some medicine the neighbor 
across the street brought me; her baby had this 
same trouble and this medicine cured it. But it 
didn't seem to help my baby and so I came to 
you." 

Now this case is, I am sorry to say, almost 
typical of what we doctors have to meet daily. 
No mother who understood the grave danger 
of such a practice would give her baby medi- 
cine a neighbor had for another baby, who 
SEEMED to have the same trouble; nor would 
any mother dare to give an infant a remedy 
which she had used for her own self, if she 
knew the danger of such a course; the injudi- 
cious dosing of the well-meaning grandmother 
was just as bad, and it is just such happenings 
that fill our cemeteries every summer with lost 
lives of little ones, who are well beloved, but 
the victims of unwise parents. Again I refer 
to our note of those mothers who regret their 



128 BETTER BABIES 

lack of knowledge ! "The Had I But Known" 
class of mothers is large, but we hope to de- 
crease their number year by year. 

I would urge that every mother read this 
chapter carefully, and that she learn to watch 
baby for symptoms; that she learn the impor- 
tance of keeping specimen stools and specimen 
urine, too, (see chapter on urine) and that above 
all else she does not try to economize by wait- 
ing to send for a doctor, but that she send as 
soon as she observes unnatural symptoms in her 
baby; this sending early may be the truest sort 
of economy; not only of money, but of life itself. 
It is a fact which mothers should also remem- 
ber, that a doctor can make a better diagnosis 
from an accurate history of a baby's illness than 
he is often able to make from the reported and 
often exaggerated symptoms of an adult. Just 
because the baby can not talk is no excuse for 
waiting to call in a physician; on the contrary 
this is an added reason for so doing. 



PROTECTION AGAINST CONTAGIOUS 
DISEASES. 

If every professional man in the land and 
every good citizen were asked to unite in 
framing one general rule by which to promote 



BETTER BABIES I 29 

the public good, I believe that all would agree 
that "Co-operation and Protection" would best 
fit the situation. In such a general rule, mothers 
should also join, for to them, as to the physi- 
cian, "protection" must first apply to health, 
just as to the lawyer, "protection" must apply 
to the public property, and to the minister, to 
the public morals. 

To every physician, and to every mother, and 
to every good citizen, it should appeal as a 
sacred duty to co-operate with the City or 
County or State Board of Health, toward the 
protection of the public from contagion, and 
this means to insure, wherever and whenever it 
is possible, public and private sanitation, and 
the use of every precaution to prevent the spread 
of contagious diseases. In many communities, 
the health officials are wise and vigilant, but no 
set of laws, however comprehensive they may 
be, nor however rigid, can ever accomplish the 
desired ends without the co-operation of the 
people for whom they are primarily designed. 
The People a Foe to Proper Protection. 

Strange to say, however, the greatest obstacle 
to the proper protection of the people is found 
in these very people themselves. This may be 
forgiven of the absolutely ignorant and unin- 
formed, but it is hard to forgive enlightened 
members of a community when the rules and 



130 BETTER BABIES 

regulations of the Boards of Health are actually 
resented and ignored. Physicians, too, often re- 
frain from reporting contagious diseases to the 
proper authorities, and, by so doing, they be- 
come themselves an actual menace to the safety 
of the community in which they live. The only 
explanation of this attitude on the part of any 
one, is that people practicing this opposition are 
suffering from an exaggerated form of selfish- 
ness, combined with an unbelievable depth of ig- 
norance. Such people do not consider the 
danger to others from infection; but they re- 
gard only the personal inconvenience to them- 
selves of having, for instance, their well chil- 
dren kept from school because there happens 
to be also one sick child; they lose sight of the 
fact that even the personal discomfort of being 
themselves isolated for a time is counter-bal- 
anced by the protection given to society from 
the grave dangers of a contagious disease. 

Physicians are daily confronted with in- 
stances where parents deliberately conceal the 
existence of a contagious disease, and continue 
to send well children to school from a house in 
which a sick child is kept; often the physician, 
himself, is powerless to prevent this, and the 
only hope for the community lies in the hands 
of the parents. Again, how often children are 
kept from public schools because of rigid health 



BETTER BABIES 131 

laws, but are sent to private schools, to Sunday 
School, and to all public places, such as parks, 
theatres, stores, and to motion picture plays. 
Absolute lack of consideration, and an abnor- 
mal selfishness, is really the cause of such neg- 
ligence. 

Ignorance May Cause Carelessness. 

But no one must overlook the fact that there 
are really many persons who do not actually 
know the many possible sources from which 
danger arises, nor do they know the necessary 
precautions to take to prevent the spread of 
certain kinds of diseases, nor how to prevent the 
spread of these diseases when they, perhaps, at- 
tack one member of a family. 

Teachers in the school room should be in- 
formed on this subject, and should, in turn, en- 
deavor to inform the children in their care re- 
garding certain fundamental points of protec- 
tion. Mothers, too, should learn all they can 
about the subject, and such is my personal faith 
in the integrity and intelligence of women, that 
I firmly believe, once the question is fully under- 
stood, that it will surely be met and handled in 
the best possible manner. 



132 eetter babies 

Vaccination a Paramount Protection. 

Of all interesting studies, regarding con- 
tagious diseases, there is no one which presents 
more food for thought than the history of small- 
pox, and its great preventative, vaccination. Yet 
even at this time there are many persons who 
disapprove of vaccination, but it is undoubtedly 
only those who have not investigated the facts 
who can possibly take this attitude. 

Vaccination is one of the greatest blessings 
which mankind has ever received from science. 
To properly appreciate the full value of Ed- 
ward Jenner's discovery of vaccination, it is 
necessary to first know something of the fearful 
mortality of smallpox in pre-vaccination days. 
It was the most dreadful of all diseases, not ex- 
cepting the plague, for that disease came rarely 
while smallpox was always present. In a 
speech made by Admiral Bentley of England 
when as Chairman of a Committee of the House 
of Commons in 1802 he investigated Jenner's 
petition for a Parliamentary Grant, he said: 
"The discovery of Dr. Jenner is, unquestionably, 
the greatest discovery ever made for the pres- 
ervation of the human species. It has been 
proven that in the United Kingdom (Great 
Britain) 45,000 persons die annually of small- 
pox, and, throughout the world, not a second is 
struck by the hand of time, but a victim is 



BETTER BABIES 133 

sacrificed at the altar of that most horrible of 
all diseases, smallpox." We could quote other 
equally significant figures to prove the early 
mortality of smallpox, for instance, in 1803, it 
was stated that 40,000 people died of the dis- 
ease each year in Prussia, 200,000 in Russia, 
and, as late as 18 11, 150,000 annually in 
France. Other conditions than death also re- 
sulted from this disease, such as blindness and 
kindred ills, all of which proves the great need 
of a protection against this scourge. That cow- 
pox conferred protection against smallpox, is 
said to have been observed as early as the mid- 
dle of the 1 8th Century, for people were quick 
to observe that when smallpox appeared, those 
persons were exempt who had been infected 
with "cowpox," or matter exuding from the 
certain sores on the teats and udders of cows. 
This called the attention of Dr. Jenner to the 
principle of vaccination with the results already 
mentioned. From 1801 to 1822, Dr. Jenner re- 
ceived 28 diplomas, from institutions of learn- 
ing and scientific societies, in every country in 
Europe, the United States and Canada. The 
value of his great gift to humanity was recog- 
nized and rewarded. 

But even in the use of vaccination there are 
certain precautions to be taken. For instance, 
the human virus should only be used once, each 



134 BETTER BABIES 

vaccination being done from the fresh bovine 
or calf limph. In order that vaccination may 
pursue a perfect course, free from subsequent 
complications, it is important that the following 
sanitary conditions be observed: 

I. The virus MUST be pure; 2, The condi- 
tion of the person to be vaccinated; 3, Asepsis 
during the insertion of the virus, and a subse- 
quent protection of the vaccine lesions; 4, Bo- 
vine purity, or a healthy condition of the ani- 
mal from which the lymph is taken. 

Vaccinating the Child. 

If a child be exposed to the possibility of con- 
tact with smallpox, there should be no hesita- 
tion to vaccination, no matter what the condition 
of the child may be. Scores of children have 
been vaccinated, even while suffering from scar- 
let fever and diphtheria in the hospitals, in 
order that smallpox might be averted, and in 
such cases no injurious result has been noticed. 

The ages at which children should be vacci- 
nated differ in the opinions of physicians, and 
also in the customs of different countries. In 
Germany, the law requires that every child be 
vaccinated during the first year, and before ex- 
posure to possible infection. Between four and 
six years, however, is, in my opinion, the suit- 
able time, although I have known many cases 



BETTER BABIES 135 

where the child has been safely vaccinated at 
birth. It is best, however, to delay vaccination 
in a poorly developed or badly nourished child, 
especially if it has the slightest tendency to 
glandular or scrofulous trouble. 

The Dreaded Dangers of Scarlet Fever. 

Perhaps the next most contagious disease to 
be considered after smallpox, is scarlet fever. 
This ill is conveyed in two ways, although there 
is some difference of opinion among physicians 
on these points. The first way in which this 
fever is contracted is directly from the scarlitina 
patient to the newly infected subject; and, 
second, through the intermediation of infected 
objects. The vast majority of cases doubtless 
result from exposure to persons suffering from 
the disease, either in its incipiency, or during 
the latter part of the disease when the skin is 
scaling or "peeling off," although the latter con- 
dition, as a means of infection, is not yet def- 
initely decided on. It is well, however, to adopt 
the safe side and keep patients isolated during 
this stage. 

Personally, I know of a case, where a three- 
year-old child developed a case of scarlet fever, 
when there was no other case in the city in 
which it lived; the source of the infection was 
a mystery, until it was discovered that a medi- 



136 BETTER BABIES 

cal friend of the family, who had been visiting 
at the house and in whose lap the child had sat 
for a long time, had, some hours previously, at- 
tended three severe cases of scarlet fever in 
another city, and had not changed his clothes. 

Another instance which can be given, is that 
of a child's contracting scarlet fever, after 
having ridden in a carriage, which, it was later 
learned had been used at the funeral of another 
child who had died of the disease; the inference 
was that a nurse, relative, or attendant on the 
dead child, had ridden in the carriage, after- 
ward used by the well child. 

Many Sources of Infection. 

From these instances, it will be seen that in- 
fection clings to such articles as clothing, books, 
letters, toys, etc. Letters are especially danger- 
ous, and all communications from infected 
rooms should be destroyed immediately they are 
received, or, better still, should not be sent at 
all. 

Toys also form a very grave source of infec- 
tion, and, of all toys, those covered with long 
hair or fur, such as the "Teddy Bears" and 
other animal toys, are the most dangerous. In 
fact, all such toys should be rigidly excluded 
from every sanitary play room, whether there 
is an infectious disease in the house or not. 



BETTER BABIES I37 

Children are most liable to scarlet fever be- 
tween the ages of two and five years, and 
negroes are less susceptible to the disease than 
whites. 

The disease is especially dangerous, because 
the entire system is infected by it, both the in- 
side and the outside of the body showing the 
presence of the ill. The throat and adjacent 
organs are usually the most seriously involved 
of any other in the body, and many cases of per- 
manent deafness have been known to result from 
scarlet fever. The kidneys, also, must be care- 
fully watched, as the disease not infrequently 
produces a more or less serious form of kidney 
trouble. 

Of course a most rigid isolation is necessary 
in this disease, not only of the patient himself, 
but of all that comes in contact with him and 
his attendants, and, by a strict adherence to this 
rule, much of the contagion resulting from in- 
dividual cases would be prevented. 

It is claimed that one source of infection, not 
usually considered in scarlet fever, is that de- 
rived from milk, but this is not an absolutely 
proven theory. 

Care of the Contagious Sick Room. 

An imperative necessity in the treatment and 
proper care of all contagious diseases, is the 



138 BETTER BABIES 

hygiene of the sick room where the patient is 
cared for; such care not only hastens the re- 
covery of the patient but it also protects. The 
attendant physician should direct the arrange- 
ment of this sick room, and his order should be 
carefully followed. It is timely, however, to 
mention here the very recent theory that sun- 
shine and fresh air are among the very most 
efficient disinfectants known. In fact, it has 
been claimed that the most thorough and care- 
ful fumigation of sick rooms, by means of chem- 
icals, is not nearly so effective as thorough 
methods of cleanliness. The New York State 
Board of Health, and the Department of 
Health of New York City, after the most care- 
ful consideration of this question from every 
view-point, and after examining all possible 
statistics on the subject, have decided that sun- 
shine, fresh air, and absolute cleanliness will 
eradicate the germs of contagious diseases and 
render the apartment in which they have oc- 
cured, harmless to the next occupant. These 
health departments give out the following direc- 
tions for the care of a room in which infectious 
diseases have existed: 

"All woodwork must be scoured with a hot 
solution of sal soda (one pound in three gallons 
of hot water), floor panels, windows, furniture, 
bedstead, etc., and then these must be aired for 



BETTER BABIES 139 

twenty-four hours. All bedding, pillows, blank- 
ets, mattresses are to be exposed to sunshine for 
twenty-four hours. Books are to be sterilized 
and fumigated by the Health Department itself. 
Books, being very difficult to sterilize, must be 
done properly. They are suspended upon a 
rack like a ladder, back to back, and subjected 
to gas generated under proper chemical con- 
ditions, and exposure prolonged, to be followed 
by exposure to SUNLIGHT, thoroughly dry- 
ing every page so that control tests show books 
to be sterile. The New York public library, 
however, does not permit books exposed to 
scarlet fever and diphtheria to be re-issued." 

This new theory is rather a radical change 
from the old method of disinfecting a room in 
which a contagious disease has occurred, and 
while scientific opinions are never absolutely 
fixed on such subjects, the change would seem 
to be warranted in the present question because 
of the test applied in Brooklyn and Manhattan; 
in the former city, where thorough fumigation 
by the old method was done, there were half 
again as many new cases, following the original 
case, as in Manhattan, where the new way was 
tried. 



i40 better babies 

Diphtheria Also a Very Contagious 
Disease. 

What has been said of the contagious char- 
acter of scarlet fever, applies with equal force 
to diphtheria, and also to membranous croup, 
which is not unlike diptheria, inasmuch as it at- 
tacks the mucous membrane. As a matter of 
fact, all diseases which attack the mucous mem- 
branes are contagious, as will be clearly shown 
by the rapidity with which a common cold 
spreads through a home, a school room, or 
among any group of persons where one is suf- 
fering from a cold. In order to protect others 
from even a common cold, which may lead to 
more serious results, every child should be 
taught never to sneeze without protecting its 
nose and mouth with a handkerchief, never to 
cough without taking the same precaution, and 
to remember always that the tiniest particle of 
the secretion from an infected nose or throat 
may carry the germ to a well person. This 
habit of protecting the nose and mouth when 
sneezing and coughing can be absolutely fixed, 
if its enforcement is begun during childhood, 
and this is a much safer and saner method than 
all the present agitation to produce the same re- 
sults among adults. Habits are formed and 
fixed in youth; they are acquired slowly and 
painfully, if at all, in later years. 



better babies 141 

Protection Against Tuberculosis. 

In any discussion of contagious diseases, it 
is impossible not to consider tuberculosis, a dis- 
ease which attacks old and young, and against 
which we are only just beginning to take the 
proper precautions. 

One of the chief sources of infection from 
this disease is in the practice of kissing little 
children. This can not be too strongly con- 
demned, and while it is difficult, if not impossible 
to detect the kiss which carries danger, it is 
safer and better to prohibit ALL INDISCRIM- 
INATE KISSING. Persons who take offense at 
the mother's saying, "Please don't kiss the baby; 
none of us do," is a person one need not con- 
sider at all. Not even the careful mother will 
kiss an infant in the mouth, and the same rule 
should apply to older children as well. 

The rules which apply to the prevention of 
tuberculosis, and which have been issued and 
distributed from time to time by the National 
Anti-Tuberculosis Association, would apply 
equally well to all contagious diseases. One of 
the main points made by these rules is that the 
attention of all state and central governments 
be called to the necessity of making and en- 
forcing proper health laws, and that it be made 
obligatory for every physician, attending a case 
of tuberculosis, to report it at once to the proper 



142 BETTER BABIES 

authorities, in order that precautions may be 
taken to prevent the spread of the disease. We 
know that this spread occurs by contact, from 
person to person, and also that the infection is 
often carried in milk; hence state laws should 
also apply to the inspection of dairies and the 
examination of cows. 

Hospitals and sanatoriums, for the treatment 
and care of tuberculosis patients, should also be 
established, and all legislation tending to that 
end should be heartily endorsed and supported 
by the people. 

Tuberculosis is a community disease; it will 
exist as long as unsanitary conditions of living 
and working exists, and its elimination depends 
upon the concerted action of the communities 
in which it exists. The subject is too broad to 
be given adequate attention here, but physicians, 
mothers, and nurses, having the real welfare of 
the race at heart, should avail themselves of 
every possible opportunity to prevent the spread 
of tuberculosis. 

The Value of Playgrounds. 

Too much can not be said of the value of 
open-air playgrounds for children. No other 
one thing is more of a protection against con- 
tagion than fresh air and sunshine. As the 
New York Health Departments have decided 



BETTER BABIES 143 

that sunshine is the best disinfectant for the 
sick room, so it is the best protection for the 
well child. 

All the arguments, used to secure the passage 
of child labor laws, are based upon the necessity 
of the growing child's having air and sunshine. 
Representative Ayres of Kansas, in a recent 
speech favoring the Keating-Owen Child Labor 
Bill, said: "All things living must come to their 
highest development under the environment of 
pure air and wholesome sunlight; a nation, to be 
great, can not be peopled with weaklings, physi- 
cally or mentally, and in order to perfect this 
strength, our children must be protected. The 
question deals with the very life blood of the 
nation; that which it is intended to protect is 
not only the present generation but to build up 
great men and women and perpetuate them for 
all time." 

This is an argument in favor of playgrounds, 
for it is directed against the reverse conditions, 
and because it means the preservation and pro- 
tection of our children I quote it here. 

The "Family Washing" Another Menace. 

In speaking of contagious diseases, we can 
not afford to forget one menace which we in the 
South must meet. That is the menace of send- 
ing out, each week, the family washing to be 



144 BETTER BABIES 

done in the homes of negro women. These 
homes should be under the inspection of our 
health boards, and should be subjected to rigid 
supervision. As it is, we can not estimate the 
danger we experience each week, when we trust 
blindly to the Fates or to chance to protect us 
from infection from this fruitful source. 

Hospitals for Contagious Diseases. 

But with all the precautions possible, the 
layman can never adequately protect the com- 
munity from the spread of contagious diseases. 
There should always be some good hospital de- 
voted to this class of sickness; in the South there 
should be a colored and a white hospital for 
contagious diseases; and when we find such in- 
stitutions in every community, then, and then 
only, will we feel that we are actually taking 
modern, sane, and satisfactory steps, to really 
prevent the spread of contagious diseases. 



COLIC. 



Kerley says that few children complete their 
first year without having severe attacks of an 
intestinal colic. In some cases the child thrives 
in spite of the attacks; in others, such a grave 
degree of indigestion exists that the condition 



BETTER BABIES I 45 

may prove most serious. The character of 
both human and cow's milk, its ready decomposi- 
tion in the intestines, with the formation of gas, 
together with the lack of development of the 
infant's digestive apparatus, explains in a small 
degree the frequency of colic in the young. 

I have seen colic occur in the breast fed as 
well as in the bottle fed infant, and in addition 
to the causes given in the foregoing, I would 
add that the higher proteid in the food of the 
infant than in that of the older child, coupled 
with constipation, and with intestinal stasis 
caused by giving food too frequently, are all 
contributory causes of colic. Cold feet, also 
fright, anger, excitement, and fatigue are often 
associated with colic, and I might add that any 
nervous mental state in the mother may produce 
colic in the breast fed infant. 

Colic should be the signal for the mother to 
call a physician, in order that he may carefully 
examine the child and determine the cause of 
this troublesome condition, and then endeavor 
to correct it. 

Treatment. 

However, until the doctor arrives, it is safe 
to give an enema of warm water and cooking 
soda, the proportions being one quart of water 
to two teaspoonfuls of soda. A hot compress 
over the abdomen is often of value, while a few 



146 BETTER BABIES 

drops of milk of assafoetida with a teaspoonful 
of soda-mint will often relieve the attack. 

Many mothers regard colic as "perfectly 
natural," and often they do not even attempt to 
remedy it; this, however, is a mistake, for colic, 
while produced by so-called natural causes, is 
NOT a natural condition, but one of more or 
less seriousness, the extent of which can only 
be determined by the physician, who should cer- 
tainly be called in to relieve the trouble, either 
by proper medication or by regulation of the 
diet, as he may determine. 



VOMITING. 



Vomiting is a SYMPTOM, NOT a disease. 
It is a reflex act, and its center is situated in the 
Medulla, or base of the brain, NOT in the 
stomach. 

The stomach of an infant at birth holds about 
an ounce, and until the first year and a half has 
passed, the shape is almost straight up and 
down. Therefore, when too much is taken or 
when food is given too often, regurgitation fol- 
lows, as a sort of safety valve for the stomach. 
In regurgitation, there is absolutely no expulsive 
effort, neither is there nausea nor restlessness. 
Vomiting, on the other hand, is produced in 



BETTER BABIES I 47 

various ways. It can be produced directly, if 
necessary, by irritating the stomach with mus- 
tard water, mineral poisons, such as sulphate of 
zinc or sulphate of copper, and usually pro- 
duces results very quickly. 

Apart from the mechanical causes of vomit- 
ing, voluntarily produced, there are a number 
of other causes which might point to serious 
trouble, or which might result in such, hence it 
is advisable to find the cause of vomiting as soon 
as possible, and then the proper remedies may 
be applied. 

Certain foods not suitable for the infant's 
stomach cause vomiting, especially where there 
is fermentation and poisons due to carnal bac- 
teria, poisoned milk, etc., as in cholera infantum. 
A dilated stomach also causes vomiting, in 
pyloric stenosis, which is a sudden narrowing 
at the union of the stomach and the first portion 
of the small intestine. As a rule, this occurs 
between the first and third week of infancy, and 
without the slightest warning. The cause of this 
condition is obscure. The mother naturally 
thinks her milk is not agreeing with the baby 
and will change to other foods, only to be met 
with the same results. This condition, when it 
does occur, should receive the attention of the 
very best physician. 



148 BETTER BABIES 

Another possible cause of vomiting is intus- 
susception, which means that one portion of 
the intestine slips into the other portion, and 
nausea and vomiting are among the earliest 
symptoms of this condition. The matter thrown 
off by the stomach in this case is first the contents 
of the stomach, then bile and fecal matter, and 
when this occurs, of course the condition is 
serious. 

In appendicitis, especially in children, vomit- 
ing is one of the prominent symptoms. 

The toxins of the blood in many acute in- 
fectious diseases cause vomiting. This is true 
in the early stages of scarlet fever, diphtheria, 
and spinal meningitis. 

Shock and fright may cause vomiting, 
through the disturbance of the central nervous 
system. When a child receives a blow on the 
head, and begins to vomit, the parent may well 
fear concussion of the brain, and a physician 
should at once be consulted. 

There is also a condition which we call cylic 
vomiting, or vomiting which comes on at inter- 
vals, and which is probably due to an accumu- 
lation of toxic matter in the system of a nervous 
child. 

There are, of course, many other causes of 
vomiting, but these are given merely to empha- 
size the fact that vomiting is a symptom of 



BETTER BABIES I 49 

more or less gravity; that it can not be safely 
overlooked, but that when it does occur, an 
early diagnosis by a competent physician is 
most certainly indicated. 



CONVULSIONS. 

Convulsions, like vomiting, are a symptom 
rather than a disease, and usually appear so 
suddenly as to terrify the mother until she is 
unable to give the baby the aid its condition 
demands. In this instance, however, as in 
many others which arise during the rearing of 
a young child, self-control is of greatest impor- 
tance, and this quality a mother should culti- 
vate to the very best of her ability. 

Convulsions are usually accompanied by a 
temporary loss of consciousness, a contraction 
of various muscles of the body, rolling or squint- 
ing of the eyes and groaning. 

The symptom is more serious in young babies 
rather than in older ones, for in the former it 
may indicate some injury to the brain during 
birth, and if this is the case, a convulsion sug- 
gests a serious brain lesion, which may termi- 
nate in early death, or which may result in 
paralysis, or idiocy, or both. 



150 BETTER BABIES 

Later in the baby's life, a convulsion may be 
due to meningitis, tumors, hydrocephalus or to 
some blow or injury to the head. In this con- 
nection, Kerley gives an illustrative case : "An 
infant eleven months old," he says, "fell from 
his baby carriage to the stone pavement. Con- 
vulsions, repeated and severe, continued, until 
the bleeding area in the brain was located, the 
skull was opened, and the bleeding vessel was 
tied." 

Indigestion the Main Cause of Convul- 
sions. 

But the most frequent cause of convulsions is 
the taking into the stomach some UNSUIT- 
ABLE ARTICLE OF DIET. In fact, over 
90 per cent, of the convulsions noted in chil- 
dren are due to some form of gastro-intestinal 
disorders, most frequently in the form of acute 
indigestion. 

Convulsions of toxic origin may usher in 
pneumonia, scarlet fever, or any other acute, 
infectious disease. Uremic convulsions, or 
those caused by acute or chronic kidney dis- 
eases, may come under the latter head. 

Dentition (teething) may indirectly be a 
cause, in producing indigestion, with its result- 
ing irritation; and toxemia may also be a pre- 
disposing cause of convulsions, and I have 



BETTER BABIES 151 

known of a convulsion occuring with each tooth 
cut by an infant. 

Another cause of convulsions is Phimosis (ad- 
herent foreskin), in male children. There are 
cases reported where the convulsions have com- 
pletely subsided after circumcision and the con- 
sequent local irritation has been relieved. 

Treatment. 

In convulsions treatment must be given at 
once, and for this reason I say again that every 
mother should keep a cool head and exercise 
calm judgment when her baby has a convulsion. 
Although the attack may be of a grave nature, 
especially if it comes at the end or during the 
progress of a serious illness, at the same time 
a sudden convulsion may indicate merely a dis- 
turbed digestion. In any event it is well to feel 
certain that you know how to administer local 
treatment until the doctor comes and that, be 
the cause of the convulsion what it may, the 
treatment you give can do no harm. 

The first step for the mother to take is to un- 
dress the child, thus loosening all possible tight 
bindings, and give it the mustard pack as de- 
scribed in the chapter entitled "Mustard as a 
Remedy." I prefer the mustard pack to the 
bath because the child is kept in a recumbent 
position while the pack is being given and be- 



152 BETTER BABIES 

cause an enema of warm suds may be easily ad- 
ministered while the pack is being given. This 
enema is always safe to administer and must be 
considered one of the forms of treatment. 

After the enema and the pack is given, an 
ice cap should be placed to the child's head and 
a hot water bag to its feet. If the doctor has 
not arrived when this has all been done then 
give two teaspoonfuls of castor oil, and if this 
is vomited repeat until it has been retained. 

As I have already said, convulsions while ter- 
rifying are not necessarily dangerous but they 
do require prompt action on the part of the 
mother. 



CONSTIPATION. 

Normal infants should have from two to 
three stools daily; while some infants keep in 
normal health with one stool, still three is not 
too many, while anything less than one good 
evacuation of the bowels should be considered 
constipation. Should such a condition exist for 
weeks or months there occurs a condition of 
chronic constipation, and there is no single con- 
dition more serious for either an infant or an 
adult than chronic constipation. In fact, such 
a condition produces a long chain of unpleasant 



BETTER BABIES I 53 

complications such as colic, indigestion, toxic 
poisoning, headache, disturbances of the liver 
functions, hemorrhoids, and in females, con- 
gestion of the reproductive organs. 

The causes for chronic constipation are num- 
erous, some authors attributing it to dietetic con- 
ditions, others declaring that it is anatomical, 
and still others that it is systemic. My expe- 
rience is, that constipation occurs in as many 
breast fed infants as it does in those fed on the 
bottle. In the bottle fed infant, it has been said 
that the casein of the milk, together with the 
fact that too little fats are taken, is the cause 
of constipation, but this is not always the case, 
because I know that there are numbers of in- 
fants who can not digest sufficient cream to act 
as a laxative, and as the same condition often 
exists in the breast fed baby who is taking four 
per cent, of fats, this theory is not tenable. While 
the cause may be in all probability partly a 
dietetic one, still, in my opinion, the peculiar 
anatomy of the gastro-intestinal tract of the 
infant furnishes the real reason for chronic con- 
stipation. When this anatomy is coupled with 
the navel band, ordinarily used, and the usual 
method of adjusting the diaper, together with 
the indiscriminate use of castor oil, we have, 
perhaps, come close to discovering what pro- 
duces constipation in so large a number of in- 



154 BETTER BABIES 

fants. The pelvis of the infant is very nar- 
row; the great length of the lower part of the 
large intestine is the cause of multiple flexures, 
instead of the single sigmoid flexure of the 
adult; sometimes this is so to such an extent that 
one of the flexures is found on the right side 
instead of on the left. The great length of the 
large intestine and the multiplicity of its flexures 
are of great functional importance. They re- 
tard the movement of the intestinal contents, 
causing the absorption of fluids, leaving the 
feces a solid mass. This being true, it can 
readily be understood how a tight binder and 
diaper would be adding fuel to the fire already 
present by the anatomical conditions of the in- 
fant. There are other causes for constipation, 
such as tumor, hernia, or any other formation, 
condition, or circumstance which will produce 
stasis of the intestines. 

Treatment. 

The treatment given in the different text 
books is all good, theoretically, but practically, 
"all signs fail in dry weather." 

I do not believe that the greater number of 
children are born constipated, although some 
authorities claim that this is an inherited con- 
dition. But I do declare that the best treat- 
ment for constipation is PREVENTION. The 



BETTER BABIES I 55 

first and most important step in preventing con- 
stipation is that the children should not be bound 
too tightly, as is so often done. In order to 
avoid this, I would again urge the use of the 
navel band and diaper as described elsewhere. 
By so doing, the baby will be given a chance to 
grow normally. Do not give castor oil just be- 
cause it is cheap and you feel you must give 
baby something. 

Aromatic cascara has been given without suc- 
cess; milk of magnesia, extra quantities of 
water, oat meal gruel, and fruit juices all are 
worth trying, but all fail at times. One of the 
simplest and best treatments is Russian oil given 
internally, and massage properly given exter- 
nally. In using the Russian oil the proper direc- 
tions should be followed, and these are: One. 
teaspoonful night and morning or three times 
a day, for an infant six months old; this must 
be persisted in, as to time given and quantity 
used; so many failures result from not follow- 
ing or not knowing the proper method of admin- 
istration. Russian oil is not, in itself, a laxa- 
tive; it is, more properly speaking, a lubricant, 
and should be given persistently and patiently, 
with the idea that it will serve the human in- 
ternal mechanism just as any lubricating oil 
serves machinery of any kind. 



156 BETTER BABIES 

Of course, in treating constipation, the proper 
diet should be carefully considered in connection 
with the use of the Russian oil. What is de- 
sired is lubrication of the sigmoid, and in 
order to accomplish this it is well for the 
stomach to receive the lubricant first. For this 
reason I usually order the oil given before the 
first normal feeding, at least one hour, and then 
before each feeding and the last thing before 
going to bed, the dose, of course, being regu- 
lated according to the age of the child and the 
severity of the condition we are trying to cor- 
rect. 

Quite recently I had a case sent me by another 
physician, of a child so constipated that the 
fecal matter when cut would seem to have grit 
in it, and there would be bloody stools with 
each action. My treatment was proper diet 
and the Russian oil, used as in the foregoing, 
together with gentle massage, and I was grati- 
fied by having a quick and sure cure. 

From all of this it will be seen that constipa- 
tion can not be neglected, if the child's health 
is to be preserved. If the mother does not 
succeed in getting the bowels to act normally 
by loosening the binder and diaper, but using 
the treatment as outlined here, I would suggest 
that she see her physician and have him make 
a careful examination, and then follow his in- 



BETTER BABIES 1 57 

structions exactly, in order to reach the best 
results. Remember, CONSTIPATION 

MUST NOT BE NEGLECTED. 



THE URINE. 

Very few persons seem to pay any attention 
to the urine of infants, and very few have any 
idea that the infant's urine is often the cause 
of serious trouble if it is abnormal in any way 
and this is not detected nor understood. 

The normal urine of the infant is perfectly 
clear at first, unless the baby has a congenital 
jaundice, when the color of the urine will be an 
egg yellow or a greenish yellow, later on a straw 
color or pale yellow, such as is normal for an 
adult. 

The quantity of the urine first pased by an 
infant is small, probably not more than from 
three to five ounces if breast fed, and a little 
more if bottle fed; the breast fed baby, while 
passing more urine than the bottle fed baby, is 
able to retain it better, as incontinence of urine 
is notable in the bottle fed baby, on account of 
the dilatation of the bladder. 

At nine months of age, the baby should pass 
about twelve ounces of urine, if it is perfectly 
normal. 



I58 BETTER BABIES 

The reaction of the urine of an infant is 
usually slightly acid, turning blue litmus paper 
a slight red. 

Occasionally it is necessary to make an ex- 
amination of the urine of infants, but it is very 
difficult to collect it, although various successful 
devices are used. In all cases of fever, es- 
pecially where the temperature is variable, an 
examination of the urine is imperative. Such 
an examination will prevent easy and often 
wrong diagnosis, such as slow fever, typhoid, or 
malaria, when a microscopic examination of the 
urine will show a case of (pyuria), or pus in 
the urine, which can readily be cured. 

Again, there are cases of retention or sup- 
pression of the urine in infants, and also diffi- 
cult or painful urination, which might prove to 
be of a very serious nature unless relieved. For 
all of these reasons, it is important that moth- 
ers should know when the baby's urine is normal 
or otherwise, in order to be able to report the 
condition to the attending physician, who will 
apply the proper remedies. 

Incontinence of the Urine. 

This term means an involuntary emptying of 
the bladder, which is a most trying condition 
to mother, physician, and patient. Incontinence 
of the urine is of two kinds; the "Diurnal," or 



BETTER BABIES 1 59 

that which occurs during the day, and the "Noc- 
turnal," or that which occurs during the night. 
The majority of cases are of the latter class, 
occuring during the time of sleep. Many moth- 
ers fail to try to control this by making the in- 
fants or small child form good habits very early 
in life, for the control of the bladder can be 
often controlled and regulated by these habits, 
if formed early enough. Of course, involun- 
tary urination is expected in infants, but by the 
tenth or twelfth month the majority of babies 
can be taught not to wet a napkin during the 
day. During sleep, the involuntary act of urina- 
tion often extends into the second or third year, 
but certainly after that time no child should 
ever wet the bed at night. If it does so, after 
persistent efforts on the part of the mother to 
improve the condition, then a physician should 
be consulted. It is almost criminal to allow 
such cases to go without attention until the 
eleventh or twelfth year, when the child be- 
comes much embarrassed by a situation it can 
not control and the urinary organs themselves 
are difficult to control even by the most skillful 
medication. Recently, an eleven year old boy 
was brought to my office with the history that 
he had been a bed wetter all his life. Of 
course there were various causes which might 
have produced this condition. There might 



l6o BETTER BABIES 

have been a congenitally small bladder, again, 
too much fluid might be taken into the system, 
thus causing dilatation of the bladder (just as 
we have dilatation of the stomach from too 
much and too frequent feeding), and conse- 
quently a weakening of the muscular tone is 
produced. 

Other causes of bed wetting, or incontinence 
of the urine are, adenoids (see article on this 
subject) and other peripheral reflexes, seat 
worms, constipation, cystitis, inflammation of 
the bladder and hyperacidity of the urine, dia- 
betis (both forms), weakness of the bladder 
muscles, lack of nervous control of the bladder 
or other systemic causes, all of which would re- 
ceive careful attention. One cause which I have 
never seen brought out before is dilatation, 
causing a temporary stasis, and this cause is 
really worth thinking about, especially when it 
occurs in the bottle fed baby. My theory is 
that the bottle fed baby takes liquids in so much 
more volume than the breast fed baby that the 
bladder is thus unduly taxed and the dilatation 
results and the consequent incontinence of the 
urine follows. 

Treatment. 

The treatment should begin early in life, and 
should be kept up persistently, until all symp- 



BETTER BABIES l6l 

toms of the trouble disappear. Mothers should 
not get impatient either with the child or the 
physician, as it often takes months to effect a 
cure, but the final result of the cure is certainly 
worth the time and money expended upon its 
consummation. 



FEVER. 



The average temperature of the normal in- 
fant, taken by rectum, is 98 to 99 degrees; chil- 
dren of extremely nervous temperaments will 
often show a temperature of 100 degrees F., 
even when every other condition seems normal. 
But when the rectal temperature of a child 
shows any thing above 100 degrees, the condi- 
tion should be considered such as to warrant 
further investigation, and my advice is that a 
physician be called, who will direct the remedy 
to be applied when the cause of the temperature 
is determined. 

For this reason, I would urge every mother 
to procure a good clinical thermometer and 
LEARN TO USE IT. Of course, if the moth- 
er is herself very nervous and excitable, the 
thermometer might often alarm her, but if she 
will consider the value to her child of an in- 
telligent use of the thermometer, she should, 
really, be helped by it, rather than the reverse. 



I 62 BETTER BABIES 

Thermometers are not expensive; they can 
be purchased for $1.00, or even less, but it is 
always well to get a reliable instrument and 
one that is tested. Often when a mother thinks 
a child "feverish," the use of the thermometer 
will convince her that she is mistaken, and it is 
quite possible that the thermometer will save 
as many visits from the doctor as it necessitates. 
In any event, if a mother can report to a doctor 
what the child's temperature is before he comes, 
it will be helpful to him in his diagnosis, while 
it is often important to take a temperature dur- 
ing the course of treatment, in order that the 
doctor might note the changes in the disease. 

Take Baby's Temperature Per Rectum. 

Taking the temperature of infants and small 
cihldren is of course, different from taking it in 
adults; all children up to the seventh year should 
have the temperatures taken per rectum ; this is a 
wise precaution, and is really the only safe way 
to take a child's temperature, until it is old 
enough to hold the thermometer in the mouth 
under the tongue. This should be at about 
seven years, but even then a child should be cau- 
tioned when its temperature is taken. 

In infants, it is often found that the surface 
temperature of the skin is actually cool when, 
as a matter of fact, the child has a high fever, 




PROPER POSITION OF TAKING RECTAL TEMPERATURE OF 
CHILD LYING IN BED. 




CORRECT WAY TO TAKE RECTAL TEMPERATURE OP CHILD 
OUT OF BED; PREVENTS KICKING, STRUGGLING, ETC. THE 
CHILD SHOULD BE PLACED ON ITS STOMACH AS SHOWN, 
AND THE FINGERS HELD TIGHT AGAINST THE ANUS, THUS 
FORMING A SORT OF SPLINT; PARTICULARLY USEFUL IN 
SUMMER COMPLAINTS. 



BETTER BABIES I 63 

and the coolness is the result of internal con- 
gestion. 

How to Take the Rectal Temperature. 

The best way to take a rectal temperature in 
a baby is to have the child lie on its stomach, for 
in this way you have perfect control of the in- 
fant; and in larger children, also, they can not 
twist and squirm or pull away, as often happens 
when a rectal temperature is taken with the 
child lying on its back. Again, if the child lies 
on its stomach, you strike the rectum first, which, 
in taking a female temperature, is to be care- 
fully considered, for I have known careless doc- 
tors or inexperienced mothers rupture the 
vagina, when trying to take a rectal tempera- 
ture. Another reason for placing the child on 
its stomach, is that in severe intestinal disorders, 
while there is straining, your fingers can be com- 
pressed on either side of the thermometer, the 
fingers acting as a sort of splint, and the baby 
can strain upward rather than downward. 

A rather amusing incident happened last sum- 
mer, in connection with the taking of a rectal 
temperature in an infant with a severe diar- 
rhea. The doctor, in taking the temperature, 
had the nurse bring the patient to the edge of 
the bed, and with the child lying on its back, 
the legs were pulled upward. The doctor then 



164 BETTER BABIES 

knelt down in front of the baby, and after 
anointing the thermometer with vaseline, turn- 
ed to introduce it; but, just as he touched the 
anus, he was treated to what the telegrapher 
would term a "dot and dash" of fecal matter, 
directly on his immaculate shirt front! The 
incident was rather embarrassing to the doctor, 
but was a good argument for taking a child's 
temperature as I have described. 

In nervous and rachitic children, the tempera- 
ture is out of all proportion to the cause of the 
disorder, and children invariably have higher 
temperatures than adults from the same cause. 
For instance, in tonsillitis, a child's temperature 
will reach 103 degrees or 104, while in the adult, 
from the same ill, it would not be over 101. 

There are several methods of relieving tem- 
perature, but my advice is, that the mother 
should never take any steps beyond a tepid bath, 
or a cold cloth to the head, without the advice 
of the physician, who will first determine the 
CAUSE of the temperature and, in removing 
this, will also remove the fever. 



BETTER BABIES 165 



"GROWING PAINS." 

The term "growing pains" is used merely to 
arrest the attention of persons who have been 
accustomed to attaching significance to these 
words, for there is really no pathological mean- 
ing to them. The condition of pain in 
young children which they are supposed to de- 
scribe is really rheumatic. There is absolutely 
no condition which produces "growing pains," 
and the sooner that this error is dismissed from 
the minds of those who indulge in it, the better 
for themselves and for the children entrusted to 
their care, as well as for future generations. 
The pains of which growing children often com- 
plain are of a gouty or rheumatic origin, and 
should be given attention. But there are many 
cases on record where mothers have paid abso- 
lutely no attention to the complaint of the chil- 
dren that they were suffering from pains in the 
joints or limbs, because they "knew it was only 
another case of growing pains;" her mother or 
her neighbor has told her this, and she has 
blindly accepted the old theory. 

Rheumatism is no doubt due to a variety of 
micro-organisms, and those which cause ton- 
sillitis can also cause rheumatism; the same 
germs, which we call staphylococcus, streptococ- 



1 66 BETTER BABIES 

cus, and pneumococcus, also causing rheuma- 
tism. Hence, if the child should complain of a 
sore throat, the mother would be just as crim- 
inal to disregard it as she would be to disregard 
"growing pains," even though the pain or trou- 
ble in the throat would develop into tonsillitis 
and then into a severe endo-carditis or inflamma- 
tion of the lining of the heart and heart-valves; 
especially on the left side. 

Rheumatism is not caused by taking cold; it 
is the result of defective assimilation, which 
causes an increase of lactic and uric acid in the 
blood, and cold only lowers the powers of re- 
sistance until these pains result and carry with 
them a chain of symptoms which are exceed- 
ingly disagreeable. If a correct diagnosis is not 
made early, complications of the heart, the 
pleura, or peritoneum occur, with even menin- 
gitis as a possibility. 

Chorea (St. Vitus' Dance) is frequently asso- 
ciated with rheumatism. Holt states that in a 
series of cases observed by him, 56 per cent, 
gave evidence of rheumatic tendency. 

If is self-evident, therefore, that the very ob- 
scurity of these diseases makes it unsafe to take 
any chances with home remedies, for a doctor 
should be called as soon as a child persists in 
complaining of pain in the joints or limbs. 



BETTER BABIES 1 67 

The only time when it is, perhaps, not dan- 
gerous to ignore pain, is after unusual physical 
exercise of any kind. Then, indeed, if the child 
complains, but shows no previous tonsillar or 
feverish trouble, you may ignore the pains. But 
if on putting the child to bed, taking its tempera- 
ture, you find a slight fever or, in more ad- 
vanced conditions, a higher fever, then you 
have a danger signal. 

However, it is the mild yet persistent cases 
of pain that often delude the mother, and it is 
to caution her against this delusion that I write 
this special chapter. 

For PAIN THAT DOES NOT LESSEN, 
CALL A DOCTOR ; there is one chance in a 
hundred that you MAY NOT need him, but 
there are ninety-nine chances that you may. He 
will direct the remedies to be applied, and you 
can not afford to rely on the "one chance." 



CIRCUMCISION. 

The mother of every male child born into the 
world should understand the sanitary need of 
circumcision. Fortunately most doctors and 
nurses already do understand this need and I 
know of one prominent physician who makes the 
prospective mother promise him that, if he is 



1 68 BETTER BABIES 

to attend her during confinement, and if the 
child is a boy, that he will be permitted to cir- 
cumcise it when he deems necessary. It is a 
well known fact that according to the Jewish 
rite all male children are circumcised on the 
eighth day after birth in accordance with a 
special law given to Abraham by the Lord, who 
said "Ye shall circumcise the flesh of your fore- 
skin, and all male children born thereafter on 
the eighth day." This law, like so many others 
still in effect in the Jewish rituals was founded 
on sanitary reasons and even the modern Jews 
who show a tendency to cast aside some of the 
older laws, still adhere strictly to the one re- 
garding circumcision. In my personal expe- 
rience I have found the general practice of cir- 
cumcision to be good, the exact time for it to be 
done to be regulated by the attending physician. 
It is a fact worthy of notice that nearly all 
male children are born with congenital phimosis, 
which unless relieved by the proper methods 
will cause symptoms which are, to say the least, 
distressing. I deem it, therefore, the duty of all 
physicians to examine every male child at birth 
and to instruct the nurse and mother as to the 
proper care of the prepuce (foreskin), or if the 
opening is too small for the urine to pass, cir- 
cumcision should be performed at once. 



BETTER BABIES I 69 

Unless the physician's directions are carefully 
carried out sooner or later adhesions will form 
with a pin point opening, the urine will only pass 
in the most minute quantities and very slowly 
or if expelled with force, "ballooning" will oc- 
cur or the bladder will become distended from 
undue retention. During the latter condition 
natural elimination is not going on properly and 
this combined with the adhesions already form- 
ed result in a variety of symptoms. 

I can not give here detailed accounts of exactly 
when an infant should be circumcised, for, as I 
have just said, a great many different symptoms 
arise from the same cause. But I would most 
strongly urge every physician to carefully 
examine each male child who is brought to him 
for treatment, giving special attention to an 
examination of the prepuce and I would sug- 
gest that mothers and nurses be informed as 
to the need of such an examination in order 
that it may not be overlooked by the physician. 

I could cite a number of cases in my own 
private practice where acute nervous symptoms 
have been almost immediately relieved by cir- 
cumcision and also cases where fever, apparent 
malnutrition and even convulsions have been 
known to yield to the slight operation known as 
circumcision. 



170 BETTER BABIES 

One instance was particularly pertinent be- 
cause the child, aged about two years, learned 
to walk well but gradually began to lose the 
power in both legs and this increased until the 
legs were practically useless. There was no 
atrophy of the limbs and the general nutrition 
was good; a number of physicians attended this 
little fellow and gradually by a process of eli- 
mination in deciding what was NOT the cause 
of the trouble, circumcision was decided on with 
the most gratifying results. Within a week 
after the operation the little fellow could stand 
with assistance and within six months his con- 
dition was normal. 

In all cases of epilepsy, especially where the 
cause is obscure almost invariably good results 
follow circumcision. In prolapse of the rectum 
and in hernia the relief of the contracted pre- 
puce will cause the severe strain to cease, there- 
by materially assisting nature in overcoming 
these conditions. 

"Better Baby Contests" Take Five Marks 
Off. 

In the requirements set by the Contests for 
Better Babies the schedule requires that five 
marks be taken off candidates if the prepuce 
be abnormal (adherent), hence mothers en- 
tering babies in such contests will do well to 



BETTER BABIES 171 

remember that circumcision counts for the 
child's condition and failure to have the baby 
cimcumcised counts against his standing. 



"TEETHING NOT A DISEASE." 

As every physician, nurse, and mother knows, 
"Teething" has long been held up as a sort of 
perennial scarecrow, which intimidates the 
parent and before which the child has often been 
sacrificed. I can not too strongly urge upon 
the mother that teething is a natural process; 
that is is not necessarily attended by stomach 
troubles of all kinds; that it does NOT produce 
diarrhea; that it is, in itself, a natural and not 
an abnormal condition; and that the average in- 
fant, in normal health, should cut its teeth with- 
out more than a passing discomfort. Dr. Roger 
H. Dennett says in regard to the discomforts 
of teething, that "those of us who remember 
how it felt when our wisdom teeth were coming 
through, know that the gums felt a little full 
and uncomfortable, but that they caused no real 
pain if there was no abnormality about them. 
The same ought to be true of the baby's first 
teeth. Perhaps he is a little fretful, or even 
wakens once or twice during the night, but even 
this is not always an accompaniment of the teeth- 



I72 BETTER BABIES 

ing process." As a matter of fact the greater 
part of teething is accomplished before the child 
is born. At about the seventh week of fetal life 
the epithelium within the mouth is thickened, 
forms a ridge, and at the same time dips into 
the embryonic tissue about to form the jaw. 
A papilla is now developed which, pushing up 
towards the embryonic tooth, forms a complete 
mould for the enamel germ to rest on, and this 
is called the dentine germ. We now have the 
beginning of the ten temporary teeth in the 
form of partitions, the enamel, and dentine 
germ, and the papilla. The connective tissue 
around these primitive teeth has at the same 
time been forming in the dental sac an investing 
membrane for each tooth. In the partitions, as 
well as in the rest of the jaw, bony tissue is 
being formed; the teeth become further sep- 
arated from each other, and by this deposit of 
bone the alveolus is formed, lined by the dental 
sac, coherent with the gum along the borders 
of the jaw. This process has taken the whole 
period of fetal life, so that the child comes into 
the world with all its temporary teeth fully 
formed within the jaw. The permanent teeth 
are formed, in so far that the enamel-germ is 
developed from. the enamel-germ of the tem- 
porary tooth as a small sac, from which subse- 
quently the development goes on, as already de- 



BETTER BABIES I 73 

scribed for the temporary teeth. The topo- 
graphical relations of the teeth at birth are as 
follows: Above, the tooth sac, the submucous 
connective tissue and the mucous membrane it- 
self, on either side, the tooth sac and the bony 
tissue. There is no bony tissue to impede the 
tooth on its way to the oral cavity. All that 
it needs to overcome is the submucous coat, the 
mucous membrane, and the dental sac, which 
is very thin. I can not lay too much strees on 
the fact that the opening of the alveolus is wider 
than necessary to allow the tooth to pass 
through. Calcification of the fangs begins, and 
as the tooth becomes elongated by means of 
this, it is slowly forced in the direction of least 
resistance, the mouth. Pressure is directed 
toward the mouth; the papilla can not be press- 
ed upon for the simple reason that where, dur- 
ing growth, blood-vessels come in contact with 
the bony substances, absorption of the latter is 
produced, the blood vessels not being affected. 

Again I definitely state that a healthy child 
proceeds with the teething process without 
systemic symptoms of any sort although I have 
observed in the bottle fed baby more difficulty 
in overcoming the sub-mucous connective tissue 
than is had by the breast fed baby. In a child of 
highly nervous temperament there might be 



174 BETTER BABIES 

some fretfulness as noted by Dr. Dennett, and 
possibly a slight rise in temperature in the even- 
ing. 

If there is noted an increased flow of saliva 
at this time, it is not necessarily because of the 
teething process as there is no intimate connec- 
tion between healthy dentition and the flow of 
saliva. But the increased flow of saliva may 
indicate a stomatitis, and for this reason should 
not be overlooked. But teething does not give 
this ill nor does it bring about summer-com- 
plaint. However, so accustomed have the moth- 
er and nurse become to connecting every ill that 
a child has at a certain age with its teeth, that the 
gravest symptoms are often overlooked and 
wrongly attributed to this cause. If a child dies 
of teething and summer complaint little is 
thought of it; let a child die of diphtheria and 
every one is horrified. It is a strange thing 
that if a child has its teeth during the winter 
season, we hear very little of "teething" as a 
disease, but it is a fact that the Board of Health 
of Atlanta, Ga., at one time accepted teething as 
the cause of death. A diagnosis of heart fail- 
ure would be far more scientific, but the same 
Board of Health would not accept that as a 
diagnosis and they would be quite right, too. 
Teething is NOT a disease; it is a natural func- 
tion, and infants suffering from stomach trou- 



BETTER BABIES I 75 

bles, which we rightly term "summer com- 
plaint," are suffering from a disease absolutely 
apart from the question of teething. We all 
know that infants are unable to withstand ex- 
tremes of heat and cold; the latter produces pul- 
monary troubles, just as the former does 
diarrhoea and other stomach and intestinal dis- 
eases; extremes of temperatures, in my opinion, 
lower the power of resistance, and the entrance 
of bacteria does the rest. 

I must repeat that mothers and nurses should 
beware of taking the responsibility on them- 
selves of diagnosing a case of diarrhea in an 
infant as a natural result of "teething;" more 
small graves are filled because of this error than 
for any one other reason. No case of summer 
complaint in a child can be passed by as "sim- 
ple" or "light;" every case should indicate the 
acute need for medical attendance; the advice of 
a neighbor, of the grandmother of the child, or 
of any friend or relative, should not be relied 
upon, but when the child begins to have too 
many bowel movements, when it shows symp- 
toms of distress after feeding, or of disinclina- 
tion to take food, IMMEDIATE medical aid 
should be sought. 

While I feel most strongly on this subject my- 
self, I do not make these statements unsupport- 
ed by other authorities, and I therefore quote 



I76 BETTER BABIES 

from the following physicians, each one learned 
in his profession, and each one of wide expe- 
rience in this particular branch of medical prac- 
tice. All of these prominent physicians have 
considered the gravity of attributing stomach 
troubles to teething; all have discovered, from 
their own experience, as well as from careful re- 
search, that teething is a NATURAL process, 
that it is unaccompanied by systemic complica- 
tions, and that it should never assume the prom- 
inence and importance in the life and health of 
a child which has been given to it, through gen- 
erations of error. 

Dr. Kerley of New York says: "It is claim- 
ed that the eruption of the teeth is a physiolog- 
ical process, and as such is not productive of 
harm. In normal, well babies, this is generally 
the case. There may be a slight fever and rest- 
lessness, with loss of appetite, associated with 
the eruption of a tooth, but the disorder is 
usually very temporary in character. Tempor- 
ary digestive disorders are frequent in the 
rachitic during active dentition; the child may be 
restless and irritable and perhaps have fever of 
a degree or two. His digestive capacity is 
lessened, and if the usual diet is continued, fer- 
mentative diarrhoea results, which may be, and 
often is, the starting point of grave intestinal 
disease. That cough, respiratory, and skin dis- 






BETTER BABIES 1 77 

eases are immediate results of dentition, is with- 
out foundation." 

Drs. Chapin and Pisek, New York: "Many 
bodily diseases, formerly attributed to teething, 
are now known to have other causes that have 
been revealed by more accurate diagnosis and 
pathology. This is a period of rapid growth 
and instability, especially of the digestive and 
nervous system. MANY TROUBLES AT 
THIS TIME ARE DUE MORE TO 
FAULTY CARE AND FEEDING THAN 
TO ANY normal physiological activity and 
growth. Still, a certain number of infants do 
show disturbances at this time that are apparent- 
ly due to the eruption of teeth, as careful ex- 
amination fails to show other causes. There 
may be evidences of nervous discomfort, shown 
by constant restlessness, fretfulness, disinclina- 
tion to take food, and various grades of indi- 
gestion. A light, irregular temperature may 
also develop, that will be aggravated by indi- 
gestion if food is forced in too great strength 
or amount. In a few cases, the infant seems 
much sicker, with high fever and severe ner- 
vous symptoms, such as semi-stupor or convul- 
sions. Rickety babies are prone to the latter." 

Holt of New York says: "At the present 
time, many good observers deny that dentition 
is ever a cause of symptoms in children, some 



178 BETTER BABIES 

even going so far as to say that the growth of 
the teeth cause no more symptoms than the 
growth of the hair. Without doubt the usual 
mistake made in practice is in overlooking se- 
rious diseases of the brain, kidneys, lungs, 
stomach, and intestines, because of the firm be- 
lief that the child was 'only teething.' 

"Although I strongly believe that the im- 
portance of dentition, as an etiological factor 
in disease, has been, in the past, greatly exag- 
gerated, and although I once held that simple 
dentition never produced symptoms, I have been 
compelled by clinical observation on this sub- 
ject to change or modify my opinion. I am now 
willing to admit that in delicate, highly nervous 
children, dentition MAY produce many reflex 
symptoms, some even of quite an alarming 
character." 

I think I have already stated that I do be- 
lieve that teething causes, in a nervous child, 
bottle fed, and during the heated period, more 
especially if the child be rachitic, restlessness, 
loss of appetite, drooling from the mouth, loose 
stools, etc., all of which, if not promptly and 
properly cared for, will often result in severe 
intestinal disorders. But these disorders are 
as much caused by the condition of the child 
and the season of the year as they are by the 
much-dreaded "teething period." 



BETTER BABIES 1 79 

When these conditions do occur, however, 
and the child is extremely nervous, with a tooth 
about to pierce through the gum but with evi- 
dent difficulty in doing so, lancing can be resort- 
ed to, to afford relief. The mere gentle rubbing 
of a tooth through will in the majority of cases 
suffice. This is especially true where the gums 
are tense, where there is a little fever and much 
apparent discomfort. However, I would urge 
that lancing or rubbing the gums be done under 
the most careful and strictest aseptic precau- 
tions as infection is easily had through neglect 
of this precaution. I would suggest also, that 
only the physician be permitted to "help the 
tooth through" as he and he alone will recog- 
nize the need for such assistance. 



SUMMER COMPLAINT. 

One of the greatest and most important re- 
sponsibilities resting on medical science, is that 
which is involved in reducing the enormous 
death rate among young children, each sum- 
mer, from what is termed "summer complaint." 
This term means illnesses which occur because 
of the changes brought about by the introduc- 
tion, into the baby's stomach, of food not suit- 
able for assimilation, and of food laden with the 



l8o BETTER BABIES 

different species of harmful bacteria : The usual 
result from the introduction of such food is 
vomiting, loose stools of various consistency 
and color, offensive odors, quantities of mucous 
and, later, straining, accompanied with bloody 
stools. 

In cholera infantum, the toxin often gets in 
its deadly work so rapidly that death ensues in 
a few hours. 

There have been countless theories advanced 
as to the cause of summer complaint, and, even 
to-day, opinions on this subject vary so widely 
that I shall not even attempt to repeat any of 
them. It is a fact, however, which we all 
positively know, that the normal, breast fed 
baby seldom, if ever, has summer complaints, 
even though he is "teething." On the other 
hand, it is equally a fact which observation and 
experience have developed, that the bottle fed 
baby (unless every safeguard is thrown around 
him), begins to show symptoms of gastrointes- 
tinal disturbances of different kinds just as soon 
as the temperature begins to get close to 80 de- 
grees F. 

What part teething plays in this trouble is 
still under argument, but that teeth do aggra- 
vate this trouble to some extent, most of us 
agree, and on this subject I have not only given 
you my own views, but those of some of the 



BETTER BABIES l8l 

best authorities in the country will be found in 
the Chapter entitled "Teething." 

On one point, almost all authorities do agree, 
and that is that BOTTLE FED BABIES CAN 
NOT RESIST EXTREMES OF HEAT OR 
COLD; their power of resistance seems lower- 
ed in climatic extremes, and in winter we have 
"Winter Complaints," such as bronchitis, colds, 
croup, pneumonia, etc. 

When we consider that the bottle fed baby 
must digest the food primarily intended for the 
calf, and that often, through negligence or 
natural conditions, this food is laden with harm- 
ful bacteria, how can we expect anything but 
trouble and death ! Let the mother be as care- 
ful as may be in preparing cow's milk for her 
baby's use, we must take into consideration that 
she can not overcome the fact that food and 
habits of the cows themselves alter the com- 
position of the milk given. For instance, when 
the grass is up and the cows are allowed to 
graze all day, you will know, if you live in the 
country, that the cows have a diarrhoea, or what 
we would call in an infant "summer complaint." 
If this is true of the animals themselves, how 
much more true it must be of the infants fed 
on this same milk, and with stomachs not alto- 
gether adapted for its use? The new grass 
must contain certain salts that produce a laxa- 



I 82 BETTER BABIES 

tive, just as a saline laxative given to a mother 
will produce loose stools in a nursing infant. 
This, indeed, would be one explanation of the 
prevalence of "summer complaint" in the bottle 
fed baby. Therefore, in the treatment of sum- 
mer complaint, we must first consider even a 
more important factor; that is, Prevention. 

How to Prevent Summer Complaint. 

In order to prevent the occurrence of sum- 
mer complaint, we must look well to all the 
conditions surrounding our infants. In the first 
place, the child should be lightly clothed; the 
coolest room in the house chosen for its use; 
the windows should be wide open night and 
day; and the child should be kept out of doors 
most of the day if the weather permits. It is 
well to have the child's bed movable, in order 
that it may even take its daylight nap out of 
doors; many mothers use the baby carriage for 
this, but it does not seem to me to be possible 
to have this big enough to permit the baby to 
move freely, or to have sufficient air circulate 
around it, as the carriage top often excludes 
the air, as it does the sunshine which it is de- 
signed to hide. 

During the heated term, the baby should 
have a tepid bath night and morning, and, if 



BETTER BABIES I 83 

at all possible, a change to the seashore or moun- 
tains is desirable. 

Of course, the food formulas you use for 
the baby should all be directed by a careful 
physician, and in the preparation of these for- 
mulas only pure, wholesome milk should be 
used. Every article used in the preparation of 
baby's food should be as nearly sterile as pos- 
sible, especially the bottles, nipples, etc. 

The careful mother will watch the baby's 
stools during the summer, and will report to the 
physician any little change in color or consist- 
ency from that which she knows is normal. In 
this connection, it is safe for a mother to re- 
member "that every little color has a meaning 
all its own," especially to the physician, who can 
tell much from this one symptom. The odor 
of baby's stools, too, is most significant, and for 
this reason the soiled napkins should be saved, 
to show the physician who is to treat the case. 

When an irregularity is noticed, and the doc- 
tor is sent for, then the mother should at once 
take the baby off of all food until the doctor 
arrives. This applies to milk especially, as 
NOT A SINGLE DROP OF MILK should 
enter the baby's stomach if its bowels are upset; 
many a serious case of summer complaint has 
been prevented by this one single precaution, 
just as many a case has been precipitated for 



I 84 BETTER BABIES 

the lack of this. All a mother should do until 
the doctor comes, is to give the baby a little 
sterile water (water which has been boiled in 
a clean vessel and cooled) and OMIT OTHER 
FOOD. 

Although a few teaspoonfuls of a solution of 
soda water (a teaspoonful of bicarbonate of 
soda) to a glass of water can be given, a tepid 
sponge bath can do no harm. If the baby seems 
to have griping pains in the stomach and bowels, 
hot fomentations should be used over the 
stomach. NEVER GIVE AN OPIATE TO 
RELIEVE PAIN, unless your doctor directs. 

The napkins of a baby suffering from sum- 
mer complaint should be placed in an antiseptic 
solution when soiled, and then boiled. This is 
a necessary precaution and should always be 
done. 

No Home Prescriptions. 

Every mother should remember that it is 
CRIMINAL for another mother, for the 
grandmother of the baby, or for a neighbor, to 
prescribe for any form of summer complaint; 
no one but a physician is competent to treat this 
trouble, and, for this reason, I will give one 
prescription myself because it has served me so 
well that I wish other doctors to know it. 

Where there is straining, and the passing of 
blood and mucous, the doctor should order the 



BETTER BABIES I 85 

following and show the mother or nurse how 
to use it in his absence. The preparation con- 
sists of 

Argyrol, 40 grains. 

Emulsion of Castor Oil 50 per cent., one 
ounce. 

This should be shaken each time it is used 
and applied into the rectum. I would advise 
the use of a hard rubber syringe, to which has 
been attached a soft rubber catheter, No. 10 
size, from which all but three inches has been 
cut off. This gives a soft rubber piece to be in- 
serted into the rectum, and, after each stool, 
the syringe should be filled with two teaspoon- 
fuls of the mixture, the catheter passed about 
two inches into the rectum, and the solution in- 
jected slowly, and the rectum held tight with 
the fingers for several minutes. This will be 
found to afford relief, and is a simple remedy 
which is well worth a trial. 



RICKETS. 

Rickets is a disorder of nutrition, occurring 
chiefly in infants and young children between 
the ages of six months and two years. It is 
readily distinguished because it affects the bones, 



I 86 BETTER BABIES 

primarily, as well as the mucous membranes, 
ligaments, and muscles, and has a profound in- 
fluence on the nervous system. 

The spleen and liver are usually enlarged, 
while the lesions are chiefly noticed in the 
bones, and owing to a deficiency of lime salts, 
the bones become very soft and pliable. Under 
normal conditions the bones are composed of 
two-thirds mineral matter, but in rachitis this 
mineral matter is reduced to one-third. This 
reduction of the mineral matter composing the 
bones is the explanation of the rachitic deformi- 
ties in the bones of the legs, the arms, and the 
ribs. In rachitic children, fontanels are not 
closed until very late, while the spine shows a 
tendency to give way, causing lateral curva- 
ture. For these reasons we find "bow-legs," 
knock-knees, "pigeon breast," together with 
spinal curvatures and square cranium, in rachitic 
children. 

Where the bone joins the cartilage of the 
ribs, enlargements occur, which we call "bead- 
ed ribs." 

Hydrocephalus is sometimes a mistaken 
diagnosis; in rickets the condition which causes 
the appearance to justify such a diagnosis is be- 
cause the skull shows evidences of thickening 
and the child acquires a broad forehead with a 
frontal prominence characteristic of rickets. 



better babies i 87 

Causes. 

The causes of rickets may be said to be first 
of all the absence of human milk from the diet 
of an infant, and this absence is noted in ninety 
per cent, of the cases. Of course, the same re- 
sult may follow human milk which is defective 
in nourishing qualities, but breast fed babies are 
less liable to the disease than those artificially 
nourished. Then, infants born of parents who 
have syphilis or tuberculosis are prone to rick- 
ets, and this should be taken into consideration 
when diagnosing a case of rickets. 

Symptoms. 

Among the first symptoms noted in rickets 
is constipation. Of course every constipated 
baby does not necessarily have rickets, but per- 
sistent and extreme constipation is a symptom 
which must be considered. Other symptoms 
are head sweating, and anemia. The sutures 
of the skull are distended, the fontanel remains 
open, as has been stated, and while this should 
close about the eighteenth month, in rachitic 
children it is often open as late as the third or 
fourth year. 

Children with rickets often have spasms of 
the larynx and general muscular spasms, be- 
cause of the effect on the nervous system. Denti- 
tion is delayed, and the teeth, when they do 



I 88 BETTER BABIES 

come, begin to decay early; this is always a 
serious symptom and should be at once given 
attention. These symptoms are the main ones 
to be noted, especially when associated with 
any tendency to spinal curvature, pelvic de- 
formities, and bow-legs. 

Treatment. 

The best possible treatment for rickets should 
be along preventive lines. Among the principal 
preventives are MOTHER'S MILK, fresh air 
and sunshine; all natural remedies, and within 
the reach of all. 

If rickets should afflict the breast fed baby, 
the milk should be examined at once, and if 
found low in proteids, then cereals, eggs, and 
meat, should be given the mother. 

If the bottle fed baby has rickets, fresh, clean, 
cows' milk, modified to suit the weight and 
digestive capacity of the child, should be given; 
also such foods as are rich in proteids, such as 
cereals, fresh vegetables, spinach, beans, peas, 
asparagus, eggs, white meats, and fish, if the 
child is old enough to eat these foods. Butter 
and cream, also fresh fruits, should be added 
to this diet. The medication and treatment to 
correct deformities should be left entirely to the 
physician, and a rachitic child should be con- 
stantly under a physician's observation and 
care. 



BETTER BABIES I 89 

SCURVY. 

Scurvy is a constitutional disease due to pro- 
longed and faulty diet, and it causes pain, and 
swelling in the extremities as well as hemor- 
rhages into the skin and mucous membranes. 

All authorities show the real cause of scurvy 
to be the use of proprietary infant foods, the 
continued use of sterilized milk (unless fruit 
juices be given) the use of condensed milk and 
cereals given too long and too exclusively. 
These foods seem to produce intestinal putre- 
faction and toxemia which seem peculiar to this 
disease. 

In the South, fortunately, we see but few 
cases of scurvy. 

I have noted that children between the ages 
of six months and two years are more liable to 
attacks of scurvy than at other ages. Just what 
chemical changes take place in the so-called 
"dead foods," or what change is produced by 
boiling which makes the use of these foods re- 
sult in scurvy, is still a question under discus- 
sion. That it is a fact we do know; WHY it is 
a fact we can not assert. 

A child who has been improperly nourished 
or artificially fed for some time will first at- 
tract attention by crying whenever it is handled, 



I90 BETTER BABIES 

the tenderness to touch being especially notice- 
able about the lower extremities. The child is 
also fretful at other times, and when turned 
over will scream aloud. The mother naturally 
concludes that it is a case of rheumatism, and 
not a few physicians make the same diagnosis. 
In neglected cases of scurvy, there is swelling 
in the joints and the gums are spongy and bleed 
easily. The face, too, is often swollen and pur- 
ple spots are found on the body. 

Treatment. 

The treatment for scurvy is very simple and 
can be accomplished by judicious diet, coupled 
with generally observed sanitation. In young 
children the treatment would consist in giving 
up all proprietary foods and putting the baby 
on fresh cows' milk with orange juice given 
morning and evening, or possibly oftener. In 
older children, fresh beef juice, potatoes, and 
green vegetables should be given and the child 
kept in the best physical condition possible. 



ADENOIDS. 



It is only within very recent years that physi- 
cians themselves have recognized the gravity of 
adenoids, which is an over-growth of the 



BETTER BABIES 191 

lymphoid tissue in the nasopharynx. The lay- 
man has been even slower than the physician, to 
understand the seriousness of the long train of 
ills which may result from this condition. 

As a matter of fact, no child is exempt from 
adenoids, and their growth is as frequent among 
the wealthy as among the poorer classes. 

Kerley, an authority on this subject states 
"that if the throats of all children were care- 
fully examined with the finger adenoid vegeta- 
tions would be found in ninety-five per cent, of 
the cases. This does not mean than ninety-five 
per cent, of children should have the adenoids 
removed, as, in some cases, the growth is fairly 
small and quite innocent." 

The prominent symptoms from advanced 
cases are the adenoid expression — a pinched 
nose, and long drawn out face; frequently, 
lateral narrowing of the alveolar arch occurs, 
with an accompanying of the undue prominence 
of the upper incisor teeth. Owing to the diffi- 
culty in breathing through the nose, the mouth 
is kept half open. Nature never intended that 
the mouth and nose should change places as to 
their usefulness, for when breathing takes place 
through the mouth, cold air laden with bacteria 
goes directly into the bronchial tubes, and often 
into the stomach. This causes post nasal 
catarrh, bronchitis, and kindred troubles; also 



I92 BETTER BABIES 

deafness, due to an encroachment on the eusta- 
chian tubes, croup, and bronchial asthma. 

Bed wetting is usually associated with ade- 
noids acting reflexly; while earache, stuttering 
and stammering, and, in infants, difficulty in 
nursing, are also associated with adenoids. 

With a knowledge of these conditions, there- 
fore, it is the duty of every mother to watch 
carefully her baby's breathing after it goes to 
sleep, and if she detects any snoring, or any 
difficulty in its respiration, she should at once 
consult a physician and have the child examined 
for adenoids. 



CHRONIC TONSILLITIS. 

While we have given some attention to ton- 
sillitis as an acute ill, is must not be forgotten 
that there is also a chronic form of this same 
disease, which is due to recurring inflammatory 
attacks of acute tonsillitis. The chronic form is 
usually found in rachitic and subnormal chil- 
dren. Such a condition is often the result of bad 
ventilation and improper hygiene. 

Various bacteria are associated with this con- 
dition, and the removal of the tonsils is indi- 
cated, if the following conditions occur: 

1. Repeated attacks of tonsillitis. 



BETTER BABIES I 93 

2. If there is indication of a constant diffi- 
culty in breathing through the nose, and if there 
is persistent snoring during sleep. 

3. A nasal voice, and deficient articulation. 

4. Deafness, and attacks of earache. 

5. Tendency to pigeon breast. 

All catarrhal affections of the nose should re- 
ceive prompt attention, and the examination for 
such cases should include a careful survey of 
the tonsils, as well as an examination for ade- 
noids. 

Many respiratory diseases in children might 
be avoided entirely if parents have this throat 
and nasal examination made early enough, and 
by a competent physician. 



SIMPLE CROUP; MEMBRANOUS 
CROUP (OR DIPTHERETIC LARYN- 
GITIS), TONSILLITIS AND 
DIPHTHERIA. 

It is highly important that the physician shall 
be able to distinguish between these different 
diseases, which are alike in some features, but 
upon the early diagnosis of which, the success 
of the treatment largely depends. 

Mothers and nurses also should understand 
the importance of early recognition of these 



194 BETTER BABIES 

diseases, so common to childhood; and, because 
it is difficult for even physicians to distinguish 
between the different phases of these respiratory 
and throat troubles, until careful investigation 
has been made, it is highly important that the 
doctor be called early in the attack, and before 
the progress of the disease has advanced to 
the danger point. 

Membranous croup is one of the most deadly 
ills that can befall a child, while diphtheria has 
long been a term to strike terror to the parents' 
hearts. While the use of the anti-toxins has 
greatly reduced the mortality in these diseases, it 
requires professional skill, experience, and 
knowledge, to use this remedy at the right time, 
and for the ill which demands it. Therefore, I 
shall give a few distinctive characteristics of 
each one of these diseases, in order that moth- 
ers may understand the grave need of skillful 
medical attendance on each one. 

Simple Croup. 

In spasmodic or simple croup, the attacks 
usually come on at night, and very suddenly. 
The cough is dry and barking, there is much 
hoarseness, the child is restless, and wants to 
be taken up and held in the arms. But there 
is little or no fever, and, if proper treatment is 



BETTER BABIES I 95 

given, the little patient is entirely well in from 
twenty-four to thirty-six hours. 

Membranous or True Croup. 

As has been said, this is one of the most 
dangerous of all the diseases of childhood, and 
as it has many symptoms in common with simple 
croup, the serious malady is often mistaken for 
the simple one. In fact, the only positive proof 
that true croup does exist, is when the Klebs- 
Loeffler bacillus is actually found, and it is ex- 
ceedingly difficult to find this germ unless the 
membrane is actually coughed up. Constitu- 
tional symptoms are usually absent, partly on 
account of the protection afforded by the very 
numerous mucous glands, and the supply of 
lymphatic vessels. These vessels connect with 
the bronchial glands. 

The main danger comes from the mechanical 
obstruction to respiration, and the extension of 
the disease to the bronchi. In uncomplicated 
cases of membranous croup, excluding the as- 
cending ones, there is little or no fever, the onset 
of the disease is gradual, and it grows prog- 
ressively worse. There is no hoarseness, and 
after a short time complete aphonia, while the 
stenosis is at first slight, and only on inspiration. 

As the disease progresses, the inspirations 
become more hurried, with dilatation of ala nasi, 



196 BETTER BABIES 

recession of the chest until, in some cases, there 
even occurs the "barrel-shaped chest;" then the 
skin and mucous membrane is of a blue leaden 
color, there is great restlessness, the eyes seem 
to have a bulging appearance and the face as- 
sumes a most pitiful expression, as though the 
little patient were begging for oxygen. 

If nothing is done to relieve the obstruction 
in a short time the child dies from asphyxia. 

It would not be wise for me to lay down here 
any line of treatment for croup, or for mem- 
branous croup. The conditions existing, when 
these ills are present, must be carefully consider- 
ed by each physician attending such a case; but 
I will say, and with as much emphasis as pos- 
sible, that every physician should be fully equip- 
ped with the necessary remedies, and, as I have 
already announced, that he should not only be 
able to apply these remedies, but should recog- 
nize the time and the need for their instant use. 
On this recognition, depends the precious lives 
of thousands of our children every year. Again 
I wish to impress upon the mother or attendant 
of every child, the serious character of EVERY 
form of croup, because ANY apparently sim- 
ple form may be, in reality, the deadly mem- 
branous croup, although unrecognized as such. 
Many little children would be alive and well 
to-day, if the mother had taken the precaution 






BETTER BABIES I 97 

to call a physician early in the disease, and had 
not waited until it was too late. The mothers 
who do wait, form that sad class which we have 
elsewhere grouped, as belonging to those who 
weep and say: "Had I but known." 

Quite recently I was called to do an intuba- 
tion, or opening of the child's throat to insert an 
air tube, but as I entered the hall the attending 
physician announced that the little one had pass- 
ed away ! From the history of this case I found 
that it, like many others, was a history of neg- 
lect. 

In order to "play safe" in all cases of croup, 
CALL A PHYSICIAN; and this physician 
should have a culture made at the earliest pos- 
sible moment, and, if in doubt, he should give at 
least 5000 units of anti-toxin; and, where the 
diseased has progressed, at least 10,000 units. 

Tonsillitis. 

Tonsillitis is not immediately distinguishable 
from diphtheria, in the same degree that simple 
croup is not at first to be distinguished from 
membranous croup. In these diseases also, the 
finding of the germ in the culture is the only 
POSITIVE proof of the existence of diphtheria, 
but there are cases when even the first and 
second cultures taken do not show the germ. In 
such cases, a physician must be guided by his 



I90 BETTER BABIES 

experience and by the clinical symptoms. The 
onset of tonsillitis is usually sudden; chilly sen- 
sations often being the first symptoms. In chil- 
dren too young to tell what is the trouble, it 
might easily be overlooked, unless the physician 
and the mother herself examine the child's 
throat to determine the first evidences of this 
disease. This examination will reveal at first a 
little reddening of the tonsils and soft palate; 
often also a slight swelling of the tonsils, while 
later the tonsils become greatly enlarged, with 
creamy or whitish spots all over them. Spots 
sometimes coalesce, giving the appearance of a 
false membrane, but these can easily be wiped 
off without leaving a bleeding surface. As a 
rule, the temperature is high, being usually 104 
to 105 degrees, which is much higher than we 
find in diphtheria. Frequently the glands at the 
angle of the jaw are enlarged, and also those 
back of the ear. Tonsillitis is a painful, trying 
disease, but it is not considered a menace to 
life, and, with proper care and treatment, deaths 
from this ill are comparatively rare. 

Diphtheria. 

Diphtheria we recognize as a disease of 
gravity. The symptoms differ, as the condi- 
tions result from a pure or a mixed infection. 
The mixed infection consists of the Klebs- 






BETTER BABIES 199 

Loeffler and streptococcus. An attack of diph- 
theria is sometimes ushered in with a chill and 
vomiting. The temperature is not so high at 
first, and unless there are complications, 101 de- 
grees F. is about the average. The child with 
diphtheria is listless, and the mother notices 
that something is wrong. The little one may 
not complain of a sore throat at all, and the 
mother is surprised when told, aften an examina- 
tion is made, that a - gray or grayish white de- 
posit is seen on one or both tonsils. Sometimes 
the patch looks yellow or buckskin color, and in 
severe cases, a dirty gray color is present, and 
the throat bleeds easily when swabbed. Pros- 
tration is very marked, and the pulse will be 
feeble and rapid. There is also difficulty in 
swallowing, and often derilium, showing the ef- 
fect of the toxin on the nervous system. 

The kidneys often suffer, and albumen is 
found in the urine. If nothing is done to com- 
bat the disease, the little one dies of toxic 
poisoning. 

Nasal Diphtheria. 

Often the membrane is found in the nose 
causing nasal diphtheria. This is a condition 
which is often overlooked by the best physi- 
cians. It sometimes occurs as a mucous dis- 
charge, often bloody and even specialists have 



200 BETTER BABIES 

made a diagnosis of Nasal Catarrh. A culture 
taken from all nasal secretions would certainly 
do no harm in order to determine the exact 
nature of nasal trouble. 

From these various diseases, all closely allied 
and all different in essential points and treat- 
ment it will be readily seen that the layman 
should never attempt a diagnosis and that by 
so doing the life of many a child has been sacri- 
ficed. 



COLD IN THE HEAD, CORYZA OR 
"SNUFFLES." 

A cold in the head usually begins with watery 
eyes, sneezing, and running of the nose, with 
sometimes a nasal tone to the voice. This is a 
very troublesome condition for the nursing in- 
fant, as with the nose obstructed for breathing, 
it is difficult for it to nurse well, thus obstruct- 
ing the mouth also. Infants, therefore, are 
most uncomfortable with a cold in the head, but 
the same is true of older children also, as they 
are very fretful and lose sleep when such a 
condition exists. 



better babies 201 

Treatment. 

The treatment for a cold in the head is simple, 
and depends for its success largely on the fact 
that it is given in time, and before the cold is 
too diffused or before it extends into the deeper 
tissues. Children with colds in the head should 
be kept in a well-ventilated room with the tem- 
perature about sixty-eight degrees F. A dose 
of castor oil should be given, also a hot mus- 
tard foot bath administered, while care is taken 
to keep the child warm immediately thereafter. 
Liquid albolene douched into the nose with a 
medicine dropper, as often as required, gives 
much relief. In fact, the children themselves 
often recognize the added comfort from this 
treatment, and often ask for the "drops nosie." 



ACUTE BRONCHITIS. 

Acute bronchitis is an infection of the bron- 
chial mucous membrane, and is a disease which 
results from a lowered vitality and from the 
child's being kept in a stuffy, ill-ventilated room 
or house. This is a disease that should never 
be neglected, and neither the mother, nor her 
good neighbor or interested friend, should ever 
undertake to prescribe for this trouble, as it 
might well be the beginning of a serious pneu- 



202 BETTER BABIES 

monia, but which could easily be aborted if 
taken in time. Until the doctor arrives, give a 
dose of castor oil suitable to the age of the child. 
Then apply a mustard plaster (two parts of 
flour to one of mustard) over the chest and back 
of lungs. Remember, that in treating the in- 
flamed lung of an infant, it is usually the pos- 
terior or back of the lung which is affected, and 
application should be placed there. 

One treatment which can be given for bron- 
chitis before the doctor comes, and which will 
really afford much relief, is an inhalation of 
steam into which has been poured ten drops 
each of creosote (beechwood) and eucalyptol 
to one quart of water. The medication should 
be placed in a tea kettle or a regular croup ket- 
tle, of which there are several makes on the 
market, and a sheet covered over the child in 
such a way that the steam be kept near the 
mouth and nose of the little one, but not near 
enough to burn it. One way of insuring this 
tent-like covering and of keeping the child safe 
is to use a small umbrella or parasol and to 
put the sheet entirely over this with the child be- 
neath the parasol, also. Then, the steam is 
inclosed and must reach the respiratory organs 
of the little sufferer, and this will insure relief 
until the doctor comes. 



better babies 203 

Pneumonia. 

Pneumonia is too dangerous a disease even to 
discuss here, but the treatment in the early 
stages is similar to that given for bronchitis, 
and can be used even in cases where pneumonia 
is suspected. One symptom of pneumonia 
which every mother should recognize as a dan- 
ger signal, is the marked change in a baby's 
respiration during sleep. If the baby has a 
cold and begins to breathe with difficulty during 
sleep, or to make unusual sounds, it may be an 
indication that symptoms of pneumonia are 
present. In any event, it is well for mothers to 
know that babies are all predisposed to diseases 
of the respiratory system in winter, just as they 
are to diseases of the digestive system in sum- 
mer, and it is never safe to disregard a baby's 
cold or to overlook any difficulty it may have 
in breathing, either when asleep or when nurs- 
ing. 



WHOOPING COUGH; ITS DANGERS 
AT LAST RECOGNIZED. 

It has always seemed to me a curious phenom- 
enon that the medical profession, as well as 
parents and nurses, will for years at a time 
calmly accept the dangers of some one disease, 



204 BETTER BABIES 

regarding it as apparently inevitable, and 
making no special effort either to allay or pre- 
vent it. Fortunately, this curious lethargy is 
fast disappearing, but whooping cough is among 
the last diseases to which the attention, interest, 
and intelligence of the community has been di- 
rected. 

The importance of proper treatment for this 
disease is now being recognized, and the urgent 
need for taking every precaution against its 
spread is at last being understood. 

All physicians will recall cases where grand- 
mothers and even, at times, mothers, will de- 
light to tell how their children, suffering from 
whooping cough, will, at the beginning of a 
paroxysm, run to a chair, place their elbows 
upon it, give a few whoops, turn pale in the 
face, and, with bulging eyes, violently vomit 
and have, perhaps, a hemorrhage from the nose; 
all of which would quickly pass, and the little 
one would soon be running about apparently as 
well as ever, until the same thing is repeated 
with the next paroxysm. 

Now such a disease in any child is not, to say 
the least, contributing to its well-being. On the 
contrary, every physician has been impressed, 
as I have been, by the emaciation and general 
depletion following an attack of whooping 
cough, as well as by the long train of evils which 



BETTER BABIES 205 

result from this disease; in fact, I rank it only 
second to measles in the bad results which often 
follow it. With the recognition of the real 
gravity of whooping cough, there has come to 
me a determination to combat the disease as 
far as is humanly possible, and with that end 
in view I have given it considerable attention, 
and I am anxious to impress every physician, as 
well as every mother and every nurse, with the 
real gravity of whooping cough, and the neces- 
sity of regarding it not as an "inevitable child- 
ish disease," which all children are "bound to 
have," but as one of the illnesses to be avoided 
and dreaded. 

With this idea in view, therefore, I would 
urge that the first step in any campaign against 
whooping cough would be to insist that all chil- 
dren suffering from it should not be allowed to 
mingle with other children, any more than if 
they were suffering with any other of the con- 
tagious diseases. These children with whoop- 
ing cough should be kept from other children, 
even in the open air, and this separation should 
be insisted upon by local health boards, who 
should make the laws against whooping cough 
as rigid as those against scarlet fever, or diph- 
theria, or even smallpox. If such laws were 
made and enforced, then mothers having several 
children would not decide to let the well chil- 



206 BETTER BABIES 

dren mingle with the one having whooping 
cough, on the worn-out theory that "they might 
as well all take it together." 

While one attack of whooping cough usually 
protects a child, yet exceptions to this rule have 
been reported. Epidemics of whooping cough 
are more frequent in the fall and spring, and 
the majority of cases occur under three years, 
while those occurring before the end of the first 
year are usually fatal. Children over ten years 
old are not subject to the disease. 

The true nature of the disease is not yet fully 
settled; many writers claim that it is a simple 
bronchial cold, associated with certain nervous 
habits of mimicry. It has also been stated that 
the disease is a lesion of either the pneumo- 
gastric, phrenic, sympathetic, or recurrent laryn- 
geal nerves. If this ground is valid, it is simply 
a neurosis. Eustace Smith says it is caused by 
the pressure of the enlarged tracheal and bron- 
chial glands upon the terminal filaments of the 
pneumogastric nerve. Personally, I believe 
whooping cough to be an infectious catarrhal 
process, which affects the mucous membrane 
controlled by the superior laryngeal nerve, and 
the value, in many cases, of purely local treat- 
ment, indicates that the abode of the germs is 
in the region when the poisonous products of 
the growth are absorbed. 



better babies 207 

Symptoms and Complications. 

It is necessary to try to recognize the disease 
as early as possible, not only because it is wise 
to place the little patient immediately under the 
best possible hygienic and medical treatment, but 
also because, by early diagnosis, other children 
in the house or neighborhood could thus be pro- 
tected from the disease. I believe whooping 
cough to be contagious throughout its whole 
course, from the very beginning of the catarrhal 
stage until the cough with expectoration ceases 
entirely. 

Complications which occur with whooping 
cough are often of a most serious nature. Hem- 
orrhages from the mouth, nose, conjunctivae, 
ears, and, in a few cases, intra-cranial hem- 
orrhages occur. 

The diseases that follow in the train of 
whooping cough are broncho-pneumonia, 
emphysema, gastro-enteritis, marasmus, vomit- 
ing, often distressing convulsions, more frequent 
in infancy, tuberculosis, paralysis, aphasia, as 
well as disturbances of the sight and hearing. 
In addition, hernia, umbilical and inguinal, also 
eneuresis, are not uncommon complications as- 
sociated with this so-called "simple" disease. 

I can not too strongly impress the mother 
with the need of early diagnosis in whooping 



208 BETTER BABIES 

cough, and also of the imperative need of im- 
mediately consulting a physician. Much can 
be done to alleviate the condition, to shorten the 
duration of the disease, and to mitigate the 
severity of the paroxysms. To let this disease 
"run its course," as so many mothers have done 
and are doing, is absolutely dangerous to the 
life of every child afflicted with it. I shall not 
direct any form of treatment here, save that 
which touches general hygiene and diet, but I 
will say for the information of all mothers, who 
are inclined to question the need or the efficacy 
of treatment, that science has done much in the 
way of successful treatment, and that the various 
vaccines, vapor treatments, as well as the reme- 
dial medical agencies, are all combining to les- 
sen the dangers of whooping cough, as well as 
to relieve its discomforts. 

Hygiene and Diet. 

A rational fresh air treatment should always 
be carried out, for an appreciable reduction in 
the number and severity of the paroxysms re- 
sults when the patient is out of doors, and the 
number of these attacks will be no greater dur- 
ing the night than during the day, if the patient 
is sleeping out of doors, or in a perfectly well- 
ventilated room; that is, in a room with a sus- 
tained temperature of from 60 to 70 degrees F. 



BETTER BABIES 209 

In very cold and inclement weather, and in cases 
where there is fever, the alternate use of two 
rooms and the thorough airing of each after 
use, is recommended. The clothing of a child 
with whooping cough should correspond nor- 
mally to the season of the year. 

Attention to the diet of a child with whooping 
cough is very important. Vomiting is often a 
persistent and, at times, an alarming condition. 
Nutritious, easily digestive food, given often 
and in small quantities, should be the rule; the 
best time to administer this nourishment is just 
following a paroxysm, as it will be more readily 
retained at this time. 

Dr. W. T. Kilmer of New York has advo- 
cated the use of an abdominal belt made of 
linen, with a strap of elastic webbing under each 
arm, and fastened up the back by lacing. He 
claims that, in addition to the relief of the vomit- 
ing, such a belt will reduce the number of the 
paroxysms, and that complications will be less 
frequent. 

In connection with this suggestion of Dr. Kil- 
mer, I will state that in a single year I was call- 
ed upon to treat not less than six cases of um- 
bilical hernia, each one the result of pertussis, or 
whooping cough. Although some of these cases 
were wearing different kinds of belts, I used Z. 
O. adhesive strips, and all made good recoveries. 



2IO BETTER BABIES 

I would suggest, therefore, the use of these 
strips during the convulsive stages of whoop- 
ing cough, as they might prevent hernia, 
and it is better to wear them a few weeks than 
as many, or more, months. 

In conclusion, I can not refrain from again 
begging physicians, mothers, and nurses to RE- 
GARD WHOOPING COUGH SERIOUS- 
LY. No matter what the attitude of the public 
has been to this disease in the past, we KNOW 
it is a grave disease; we KNOW it can be les- 
sened in danger and severity; and every careful 
mother, who would preserve and conserve the 
health of her child, should at once place it un- 
der the care of a good physician when symp- 
toms of whooping cough appear. The last note 
of warning may be sounded on this subject by 
the following quotation from the latest statistics 
of the U. S. Government for 19 14-15 as to 
causes of death: "The principle causes of 
death," says this report, "from the childish 
maladies — whooping cough, measles and scarlet 
fever, were together responsible for no fewer 
than 15,617, the rates for the three diseases 
being separately 10.3, 6.8 and 6.6, respectively. 
In 1 9 13 measles caused a greater mortality than 
either of the other two but in 19 14 WHOOP- 
ING COUGH HAD THE FIRST PLACE." 



BETTER BABIES 211 



CARE OF THE TEETH. 

"Preparedness" might well be the watchword 
with which we regard the teeth, for they stand 
like white sentinels guarding the most important 
highway of the body; a highway which may lead 
either to efficiency or to destruction according 
as we direct. The teeth are, indeed, mighty 
machines which prepare our food for digestion, 
and which thereby render powerless those ene- 
mies of human health, the bacterial fermenta- 
tions. 

The teeth should last until old age, if they are 
properly cared for after they appear in an in- 
fant's mouth, and if proper nutrition is given 
before the infant comes into the world at all. 

Even the young child whose temporary teeth 
are uncared for will soon be afflicted with large 
cavities into which the food collects, giving not 
only pain, but causing fermentation, and the for- 
mation of toxines which enter the system. With 
decayed teeth mastication does not take place 
properly, and soon the stomach and the intes- 
tinal tract rebels; and soon there begins the first 
link in a long chain of ills, including gastroin- 
testinal indigestion and kindred troubles. In a 
child thus afflicted, peevishness, restlessness, loss 
of appetite, liver inactivity, indican in the 



212 BETTER BABIES 

urine, and irregular temperature result. Natur- 
ally the power of the little one's resistance is 
lowered; it soon becomes emaciated and grows 
into a pitiful spectacle. 

Children who have been artificially fed, who 
have had summer complaint or other exhausting 
diseases, should be taken to a dentist early in 
life. It is the duty of the physician attending 
such children, and, indeed, ALL children, to 
make a careful inspection of the mouth and 
teeth and then urge that the children be placed 
under the strict supervision of a good dentist. 

Nurses, too, should always examine the teeth 
of the children placed in their care, and the con- 
dition of the mouth reported to the mother and 
to the physician. The cleaning of the teeth 
should be one of the first duties of a nurse when 
called in to a sick child; fortunately this is being 
better and better understood each year, and it 
is a most progressive step. 

Preserving the Milk Teeth. 

The milk teeth should be preserved as long as 
possible and should be filled when necessary. 
Until the child is old enough to brush its own 
teeth, the mother or nurse should perform this 
service for it. Twice daily is not too often; in 
fact oftener might be even better, but certainly 







THE MIRROR TOOTHBRUSH DRILL: A HABIT OXCE FORMED 
OP WATCHING ONESELF CLEAN THE TEETH IS A HABIT OF 
INCALCULABLE VALUE . CHILDREN. ESPECIALLY ENJOY 
THIS METHOD AND WILL READILY ACCEPT IT IF TOLD TO 
DO SO. 



BETTER BABIES 213 

each morning and evening the brushing of the 
little teeth should be carefully done. 

By a little maternal diplomacy the children 
can be taught not only how to brush their own 
teeth but also the importance of doing it and 
doing it well. It is just as easy, too, to teach a 
child the correct way of brushing the teeth, 
which is up and down, and NOT from side to 
side of the mouth as is so generally practiced, 
as it is to teach the wrong way. In order to 
make the brushing of the children's teeth almost 
a pastime, I would suggest that the mother let 
the little one stand in front of a mirror and 
watch its own self brushing its own teeth. "Just 
like a big man," or with some such childish for- 
mula. This plan of brushing the teeth before 
a mirror is one that is good for adults as well 
as for children; by it one can see just what the 
motions mean, how well they are meeting the 
purpose intended, and with a child it will soon 
be a sort of game, and will not only assist the 
memory, but will be actually attractive. Mir- 
rors are not expensive, and one can be placed 
anywhere for this purpose. I hope mothers and 
nurses will try this plan, for it will prove most 
helpful in teaching children to care for their 
own teeth. (See illustration). 

I deem dental examinations as important as 
medical examinations, and I think that there 



214 BETTER BABIES 

should be free dental clinics for public use, just 
as there are free medical clinics. The question 
of expense in caring for the teeth is always one 
to be considered, and in order that the people, 
as a mass, may be induced to spend the neces- 
sary money on their teeth (if they are able), 
they must be educated into an understanding 
and recognition of the importance of this step. 
For this reason it would be a good plan to have 
large and attractive placards, placed in schools, 
sanitariums, and public buildings where many 
people congregate, which bear the legend or 
question "Good morning! Have you brushed 
your teeth?" 

The dentist, like the physician, is the family 
friend, and should be so considered and so called 
upon at all times. 

Teeth are a medium for carrying disease; de- 
cayed teeth will hold the germ of diphtheria for 
many months, and a prominent dentist tells the 
story of a large public school in which an 
epidemic of diphtheria once broke out, and 
every effort was made to discover the source of 
the infection. Finally, the teeth of the children 
were examined, and those of a little boy who 
had had a bad case of diphtheria several months 
before, were found to be badly decayed, and on 
closer inspection were found to be filled with 
the deadly germ. 



BETTER BABIES 215 

In cleaning children's teeth a soft small brush 
should be used; the handle must be long enough, 
however, to permit the bristles reaching all parts 
of the teeth, front and back and on the ends. 
The brushing should begin with a slight down- 
ward and then an upward rotary motion, then 
across as a sort of finish; as I have already 
stated, the across motion is by no means suffi- 
cient to clean the teeth. 

Precipitated chalk is the basis of all good 
tooth powders, therefore it is the best powder 
for cleaning the teeth, but three times a week 
is often enough to use this or any other powder. 
The daily cleaning should be done with clear 
water into which has been dissolved a little soda, 
and this is as good as any of the tooth washes 
on the market. Of course good dental creams 
are not to he ignored, but they are not necessi- 
ties. The main NECESSITY in caring for the 
teeth is to do it in time, for here, indeed, a "fill- 
ing in time saves nine." 



DO SWEETS INJURE THE TEETH? 

There has always been a great diversity of 
opinion as to whether the eating of sweets in 
childhood does or does not have a direct local 
effect upon the teeth. That there should be 



2l6 BETTER BABIES 

such an effect does not appeal to my reason. 
When we consider that the enamel of the teeth 
is the hardest structure in the body, and that 
this enamel is only two per cent, water and that 
it effectually protects the softer dentine which 
forms the next layer in the tooth construction, 
and that this dentine in turn surrounds the nerve 
centers, it certainly seems difficult to believe that 
any substance which remains only a short time 
in the mouth could penetrate these protecting 
surfaces and succeed in attacking the vital por- 
tion of the teeth; especially if such a substance 
is not, in itself, of a deadly corrosive or destruc- 
tive nature. Yet, from time immemorial, it 
has been handed down to us as an axiomatic de- 
cree that the eating of candy or other sweets 
does have a direct effect on the teeth, causing 
rapid decay, and thereby preventing the proper 
grinding of food, and eventually causing 
stomach or intestinal troubles with all the myr- 
iad dangers attendant upon malnutrition. 

While we have been able to disprove many 
of the old accepted ideas, such as the cherished 
fallacy of teeth causing summer complaint in in- 
fants and thus increasing the death rate at an 
alarming ratio, because of this so-called "nat- 
ural" cause, yet it is more difficult to demon- 
strate the fallacy of other theories where condi- 
tions are less clearly defined. 



BETTER E ABIES 217 

I have considered carefully what candy eat- 
ing really does for the teeth, and apart from 
the hard stick candy which might injure the cut- 
ting surfaces of the teeth, or the tough chewing 
candy which might have a similar effect by dull- 
ing the surfaces exposed to it, it does not seem 
probable to me that further injury could be 
done to the hard enamel by actual contact with 
sweets. We have been told, however, that often 
the solution of sugar or glucose of which the 
average candy is made, causes a process of fer- 
mentation which results in lactic acid, and that 
this acid does attack the enamel and acts direct- 
ly upon it, thus causing decay by injuring this 
hard surface and hence exposing the dentine, 
which is, in turn, similarly attacked until at last 
the vital structure of the tooth is reached. 

When Sugar Does Ferment in the Mouth. 

But now let us see what actually happens 
when glucose or sugar does ferment in the 
mouth. If the sugar or glucose is held in the 
mouth long enough at the normal temperature 
of the mouth, which is 98.6 degrees, this fer- 
mentation will produce CO2 and alcohol, and 
later acetic acid. Now alcohol is really a pre- 
servative and therefore CO2 must be the dan- 
gerous element. But can this be true? As a 
matter of fact, there is absolutely no evidence 



21 8 BETTER BABIES 

in support of the destructive quality of carbon- 
dioxide, and even if this apparently harmless 
gas could effect the teeth there is still another 
reason why its dangers are minimized. We all 
know that after eating sweets we get very 
thirsty and usually take water immediately, thus 
diluting the sugar which may remain in the 
mouth. The reason for this thirst is that sugar 
has so great an affinity for water that as soon 
as it reaches the stomach, water is taken up by 
a process of dialysis through the walls of the 
stomach and Nature, to compensate for this de- 
mand and the consequent deficiency of fluid, de- 
mands water from the mouth. The result is 
that the ample washing of the mouth after eat- 
ing sugar would seem to point to yet another 
reason against the theory of tooth decay from 
contact. 

It has also been determined by testing with 
litmus paper that in from one to six hours after 
eating sweets the influence of this acid, even if 
it should be harmful, had disappeared, for there 
is no trace of it in the mouth within the period 
of time mentioned. Acetic acid, however, does 
not have any effect on the enamel; this I have 
proven by actual test. 

Lactic acid in appreciable quantities will at- 
tack the enamel of the teeth, causing a jelly- 
like substance to form thereon. But the lactic 



BETTER BABIES 2IO, 

acid foods, such as buttermilk, as well as many 
of the present day foods which are prepared 
from lactone ingredients, are too weak in lactic 
acid to have any direct effect. 

The effect of a solution of lac.tic acid of the 
proportion of one dram to the ounce, when ap- 
plied to a tooth, I have proven by direct experi- 
ment. 

While it is undoubtedly true that children's 
teeth do decay, often even when the utmost 
parental care is given to them, still I am alto- 
gether uncertain as to the real cause of the trou- 
ble, for I firmly believe that we have not found 
the solution in the one phrase "too much 
sweets." 

Of course I know there are many stomach 
troubles which might result in acid formation 
in the mouth, which directly injure the teeth, 
and such conditions might possibly result from 
excess of sweets in the stomach or from other 
dietetic indiscretions — but that contact in the 
mouth with even the excessive quantities of 
sweets which the normal child craves, does not 
appeal to me as a logical reason for decayed 
teeth. 

However, we have no real working theory as 
to the real reason for decaying teeth in children; 
personally I wish we did have, for it would give 
us a very decided advantage of being fore- 



220 BETTER BABIES 

warned and thus fore-armed in our continual 
warfare against disease in childhood; — a war- 
fare the success of which means not only the 
preservation of the individual, but the actual 
physical advancement of the entire human race 
as well. 



ANTIDOTES. 

In every household, accidents do occur despite 
the best efforts of the parents. While I can not 
urge too strongly that all poisons, used for any 
purpose whatever, be put away carefully BY 
THEMSELVES, and that those which are kept 
in the family medicine chest be labled in red let- 
ters, be put in boxes or bottles totally different 
from those of ordinary medicines, still accidents 
DO happen, and it is to equip the parent for 
such accidents that I have prepared this list 
of simple antidotes. Every poison, swallowed 
accidentally or intentionally, requires prompt 
and efficient treatment if its danger is to be over- 
come. This treatment, in the majority of cases, 
MUST be administered in the home, and long 
before it is possible to secure the services of a 
physician. I shall, therefore, give the antidotes 
in as plain and simple a form as possible. I 
shall not attempt to discuss the symptoms of 



BETTER BABIES 221 

poisoning, nor what is termed the physiological 
antidotes, but I will say that above all else it 
is very important that the person administering 
the antidote keep a cool head, while some other 
reliable person should at once call a doctor. The 
antidote which I shall list beside the poison 
taken, should, of course, be the one used, but as 
a general rule it is always safe to give an emetic 
after most poisons, unless carbolic acid has been 
taken. A teaspoonful of syrup or wine of 
ipecac, repeated in fifteen or twenty minutes un- 
less the desired effect of emptying the stomach 
shall occur before the repetition of the dose. 

Another good emetic, and a perfectly harm- 
less one, is a tablespoonful of common salt to a 
glass of warm water, to be drunk freely; a tea- 
spoonful of mustard to a glass of hot water, 
also drunk freely, is another excellent emetic; 
alum is also given, the proportion being a tea- 
spoonful to a tumbler of water; this also can be 
given freely. 

These preparations, ipecac, mustard, salt, and 

alum, should be kept in a convenient place which 

is known to more than one member of a family, 

and the same is true of all the antidotes given 

in the following list: 

POISONS: ANTIDOTES: 

Acids; acetic, muriatic, Do not give an emetic, but 
sulphurous, nitric. magnesia, chalk, soda, fol- 

lowed by soothing drinks or 
sweet oil. 



222 



BETTER BABIES 



Carbolic Acid; creosote; 
Oxalic Acid 

j Acid Hydrocianic 
\ Acid Prussic 

Aconite 

Alcohol, brandy, etc. 



Alkalies (Ammonia, lye, 
caustic potash.) 

Arsenic (Fowler's solu- 
tion, Paris Green, 
Rat Paste.) 



Chloroform 



Alcohol internally, oil intern- 
ally, whiskey, epsom salts. 

Emetic; then magnesia; then 
soothing drinks, milk, olive 
oil, etc. 

Fresh air, ammonia to nos- 
trils, cold douche to face, 
artificial respiration. 

Emetic; no pillow under head; 
free stimulation. 

Emetic; cold douche on head; 
warmth, artificial respira- 
tion. 

Vinegar or lemon juice, fol- 
lowed by soothing drinks 
or oil. 

Emetic followed by mixture 
of Tincture of Chloride of 
iron and calcined magnesia, 
baking soda. Then white 
of egg, soothing drinks or 
alcohol. 

Cold Douching; friction of 
skin; inverting the child, 
artificial respiration. 

Gas; illuminating gas Fresh air, ammonia to nos- 
or coal gas trils; cold douche, artificial 

respiration. 

Iodine Starch or flour, mixed with 

water, given freely, then 
emetic followed by sooth- 
ing drinks. 

Opium; includes lauda- Emetic, if used immediately; 
num. paregoric, a few strong coffee, keep the child 
awake and breathing by 
cold douches to head and 
spine, walking, etc. Arti- 
ficial respiration. Physician 
will use physiological anti- 
dote, atropin, or perman- 
ganate of potash. 



soothing syrups and 
morphine. 



BETTER BABIES 223 

Phosphorus. Rat poi- Emetic, as sulphate of copper, 

sons and roach poi- one to three grains in solu- 

sons, match heads. tion, every ten minutes until 

vomiting begins; then ep- 

som salts or magnesia to 

open bowels. 

Spoiled food. Emetic, followed by castor oil 

or citrate of magnesia. 

Strychnine. Emetic, followed by tannic 

acid, Bromide of Potash 
freely, or Chloral. 



THE MEDICINE CABINET. 

Every household should be supplied with a 
medicine cabinet; there are a good many styles 
on the market, but the majority of these are 
made to sell, rather than to serve as a practical 
receptacle for home remedies and those pre- 
scribed by the physician. 

These remedies should be easily accessible, 
and safe from the child's reach. The medicine 
cabinet to be useful must be practical, therefore, 
whether it be a cabinet built in the home, (which 
is usually placed in the bath room), or one that 
is purchased in a store. The really practical and 
safe cabinet should consist of at least three com- 
partments; first, a poison closet with a door with 
lock and key; the door should be plainly mark- 
ed POISONS in large letters, and near this com- 
partment, or on a separate shelf within it, should 
be kept all antidotes. Then there should be 



224 BETTER BABIES 

two other compartments, in which could be kept 
the remedies for home use, and those prescribed 
by the physician, which should always be kept 
separate. 

The great objection to most cabinets is that 
the shelves are built too deep, allowing a person 
to place two or three rows of bottles or pack- 
ages on a single shelf, one behind the other, 
which invariably results in the bottle you need 
most imperatively being the last one which you 
are able to find in case of emergency, without 
going through the entire case. The shelf, there- 
fore, of the ideal medicine cabinet should only 
be deep enough to hold one bottle, but it should 
also be long enough to accommodate the re- 
quired number. 

Another important point in selecting and 
placing a medicine cabinet is to have it placed 
where there is always a good strong light in 
front of the cabinet, and where it is possible to 
also have a good artificial light before it, for 
use during the night or on a dark day. If the 
medicine cabinet is built with the narrow long 
shelf, and is well lighted, there should be no de- 
lay in finding what is needed, especially if every 
bottle is placed with the labels turned outward. 

I have seen a rather unique, yet perfectly 
practical medicine receptable, in the form of a 
chiffonnier, which was enameled white and 



BETTER BABIES 225 

placed in a good light in the bath room. The 
top drawer was used for poisons, and medicines 
designed for external use, antiseptic solutions, 
etc. ; it was wide enough to be divided into two 
compartments, in one of which was kept anti- 
dotes. The next drawer was devoted to home 
remedies, and the next to prescribed remedies 
and dressing for wounds, flannel for hot applica- 
tions, and soft cloth, thin and porous, for 
making poultices. The advantage of the 
chiffonnier was that the bottles could be seen in- 
stantly, as they were all well corked and laid 
down flat, labels uppermost. 

The two lower drawers of this "cabinet" 
were devoted to the use of empty bottles and 
boxes, especially small tin boxes, empty salve or 
ointment jars, etc. The entire receptacle proved 
practical, useful, and safe, for the poison drawer 
was kept locked, although the key was always 
to be found in the drawer devoted to home rem- 
edies. The suggestion of using a chiffonnier 
thus is worth considering. 

Remedies to be Kept in the Medicine 
Cabinet. 

In keeping certain useful remedies in the 
family medicine cabinet, I would suggest that 
the paregoric be kept in the "poison" compart- 
ment, the key of which is held by the mother 



226 BETTER BABIES 

herself. I make this suggestion because I know 
of cases where the nurse (usually the beloved 
"old mammy") will be guilty of using paregoric 
to "pacify" baby. Perhaps she does not know 
the danger, but certain it is that danger there is, 
and it often happens that the mother never does 
discover the habit of the nurse until after she 
has left her service. Then the question arises 
as to why "baby is so fretful;" can it be pos- 
sible "it misses the nurse?" "No," I would 
answer in most cases; "it is much more possible 
that it misses the 'dope' which nurse has been 
in the habit of giving it, and which really has 
endangered its life." 

After guarding the paregoric, therefore, let 
us consider the other articles in your poison com- 
partment; — all remedies for external use, such 
as liniments, camphorated oil, etc., should be 
kept locked. Also bichloride or cyanide tab- 
lets (pink) for disinfecting purposes, all anti- 
septic washes, lysol, carbolic acid, alcohol, and 
all opiates such as laudanum, paregoric, etc. 

The family medicines every home should have 
on hand are: castor oil, olive oil, Russian oil, 
Milk of Magnesia, Aromatic Cascara, lime 
water, Aromatic Syrup of Rhubarb; Milk of 
Assafoetida, Syrup of Squills, syrup or wine of 
Ipecac; aromatic Ammonia, Rochelle and Ep- 
som Salts. Phosphate of Soda, Bicarbonate of 



BETTER BABIES 227 

Soda (pure), Essence of Peppermint, and 
Jamaica Ginger. There should also be a supply 
of adhesive plaster, sterile gauze, and bandages 
of assorted sizes. These should be kept to- 
gether, with a good pair of sharp scissors, 
always in the medicine cabinet. 

I have already mentioned the old linen, flan- 
nel, and old soft muslin for poultices, and we 
will, of course, assume that every household has 
a good hot water bag, a good ice cap, and a 
fountain syringe in perfect condition with all 
its attachments. 

I would suggest, also, that a home in which 
there are children be equipped with some sort 
of apparatus for heating water at night or for 
giving a hot drink. The small gas stoves or 
the electric stoves are easily procurable, but the 
cheapest of these appliances is the solid alcohol 
stoves, which can be bought for fifty cents. The 
medicine cabinet should be equipped with a cup, 
saucer, and spoon, and also with a measuring 
glass for administering medicines, a dropper, 
and a set of measuring spoons. These come in 
aluminum, and are in three sizes; one ordinary 
teaspoon, one-half and one-quarter teaspoon 
size. The average family teaspoon is not a 
medicinal measurement and care should be taken 
that medicines are given exactly as ordered. 



228 BETTER BABIES 

Attention to these simple precautions will 
often be found well worth while, for here again 
we will see that "an ounce of prevention is worth 
a pound of cure." 



MUSTARD A GOOD REMEDY. 

The Mustard Plaster. 

My experience has taught me that very few 
people understand how to make a good mustard 
plaster, that is to say one from which the full 
benefit of the mustard will be derived. The 
reason for this failure is that almost every one 
uses boiling, or very hot water, in mixing the 
flour and mustard. It must be remembered that 
mustard is the sifted farina made from the 
mixed seeds of the black and white mustard. 
The oil, which is the active ingredient, does not 
exist in the free state, but is developed by the 
reaction of each other in the presence of water, 
of Sinigrin (Potassium Myronate), and 
myrosin; to produce this, the water should 
never be hot, as reaction does not take place 
except at moderate temperatures, nor does it 
take place in the presence of vinegar, which is 
also used often in making a mustard plaster. 
To the presence of this oil, alone, is due the 
counter-irritating or rubefacient properties. 



BETTER BABIES 229 

Mustard plasters should be made in the pro- 
portion of one to two, one to three, or one to 
six parts of flour, according to the purpose for 
which it is to be used. The physician should 
always dictate the strength, size, shape of the 
plaster, exactly where it is to be applied, how 
long it must be left on, and how often repeated. 

Mustard plasters should be spread on a thin, 
porous cloth, and should be thick enough to be 
moist without being too wet; if it is desired to 
warm the surface of the plaster before applying 
it, this can be done by holding it before an open 
fire, by applying it for a few moments to a hot 
water bag filled with very hot water, or in any 
other similar way. 

Mustard Baths. 

In cases of shock, collapse, convulsions, or 
sudden congestion, nothing serves the purpose of 
a restorative as well as the mustard bath. This 
is particularly true when the congestion is of 
the brain, lungs, kidneys, or any of the internal 
organs. Nothing so surely helps the flagging 
heart as a mustard bath, and every mother 
should understand how to prepare this bath and 
how to use it. 

To make a mustard bath effective, three or 
four tablespoonfuls of mustard must be mixed 
into a thin paste with luke-warm water, then 



230 BETTER BABIES 

add this to plain warm water, about five gal- 
lons, at a temperature of about no degrees F. 
The child should be kept in this bath about 
five or ten minutes, then taken out and wrapped 
in a blanket. If the feet are cold after the bath, 
a hot water bag can be placed near them, and if 
there is fever, an ice cap should be applied to 
the head. This treatment is very soothing and 
relaxing, and will usually induce a natural, quiet 
sleep. 

Hot Mustard Pack. 

In many instances, I much prefer the hot 
mustard pack to the bath by complete immer- 
sion. The mustard pack is prepared in the 
same way as the bath, only instead of putting 
the child in the bath, a large bath towel is dip- 
ped in the solution, then wrung out, and en- 
veloped about the child from the neck down. 
Over this is put warm blankets, and the hot 
water bottle is put to the feet, and the ice cap 
to the head, if necessary, as is done after the 
mustard bath. This has the advantage over 
the bath, inasmuch as the child is kept in a re- 
cumbent position, while medication or enema 
can be given with less strain on the child. The 
mustard pack can be repeated as often as neces- 
sary. 



better babies 23 i 

Hot Baths. 

Ordinary hot baths can be given in the same 
way as the mustard baths, with similar care 
taken after the bath to keep the feet warm and 
the head cool. 

Hot Fomentations. 

When a hot fomentation is ordered by a phy- 
sician, it means that flannel or soft cloths must 
be dipped into very hot water, and then wrung 
out and applied over the painful or congested 
part. One way to have this cloth as hot as pos- 
sible, is to wring it in a towel and apply to the 
part needing moist heat. This is especially 
effective in colic, congestion of the liver, etc. 
One way of keeping the moist heat is to apply 
a very hot water bottle directly over the moist 
cloth; the bottle must not, however, be too full, 
as the weight is undesirable. 



REFRIGERATORS. 

No book, which concerns itself with the safety 
of the child, is complete without some mention 
of the need in the home of a good, reliable re- 
frigerator. I have asked myself the question 
many times, without intending to be humorous, 



232 



BETTER BABIES 



either, "When is a refrigerator NOT a re- 
frigerator?" and the answer has come: "When 
it does not refrigerate;" and I regret to ac- 
knowledge that this is true of many so-called 
refrigerators. Such a useless piece of furniture 
is actually dangerous to the health, and even 
the life, of a baby as well as of the whole fam- 
ily. Because a refrigerator is kept closely shut 
up, because it is often in a rather dark, "cool" 
place, and because, for these reasons, it is some- 
times overlooked by the housekeeper, it be- 
comes in many cases an actual menace. 

Every careful mother should keep a ther- 
mometer in her refrigerator, in order to see if 
the temperature of the interior is sufficiently low 
to enable her to safely keep milk therein, for 
all milk MUST be kept at 50 degrees F., if it 
is designed to keep it safe; and for this reason 
it is safer to keep the milk standing actually 
upon, or beside, a block of ice. 

Food having pronounced odors should not be 
kept in the same compartment with milk, butter, 
or cheese, as these articles of food readily ab- 
sorb all odors. The various compartments of 
the refrigerator should be cold enough to pre- 
serve the food placed in them, and the use of 
the thermometer is the only way of determining 
whether or not this is the case. 



BETTER BABIES 233 

Nothing in the house requires more perfect 
cleanliness than the refrigerator. It should be 
thoroughly washed out with a strong solution 
of cooking soda or, better still, sal soda, and 
this should be poured, very hot, down the drain 
pipe, in order to keep it free and clean. The 
shelves, sides, and even the refrigerator doors 
should be scrubbed at least once a week, and 
washed daily, while the ice chamber should be 
treated in the same way; a strong household 
ammonia being added to the soda solution for 
this purpose, as our manufactured ice is, itself, 
often filled with impurities. Care of the re- 
frigerator will help to keep the doctor away. 
Try it! 



WONDERFUL WORK OF THE MOTH- 
ERS' CONGRESS. 

I have already stated that many communities 
are helping mothers to have better, stronger, 
and healthier babies. This merely means a 
wise effort to produce a citizenship which shall 
be worthy of our great republic. 

The Mothers' Congress is a nation wide band 
of organized mothers whose sole object is to 
perfect childhood. The National President of 
this organization, Mrs. Frederic Schoff, has 
tersely expressed the whole object of the Moth- 



234 BETTER BABIES 

ers' Congress in the following extract from one 
of her addresses to parents. She says: 

"There can be no real progress in promoting 
child hygiene until definite, successful, and com- 
prehensive measures are set in motion to enlist 
those who are the actual caretakers of the chil- 
dren. There are several groups of people whose 
support must be enlisted before real progress 
can be made. Physicians are already interested. 
Parents, boards of health, educators, and city 
councils still need to be aroused and stirred to 
a realization that infant mortality is prevent- 
able, and that being a fact, that it is criminal 
NOT to prevent it. . It takes time to 

batde down the old wall of belief that mother 
instinct teaches a woman all she needs to know 
about child nurture. So strongly has this be- 
come an accepted part of our life, that no recog- 
nition of woman's life as homemaker, wife, and 
mother is given in her education. To help her 
in her great work, the Mothers' Congress has 
had to devise temporary means to reach her 
where she is, to awaken her responsibility to 
the welfare of her children, and to guide her 
in the study of child nurture." 

In the foregoing, Mrs. Schoff has sounded 
the keynote of the work which is badly needed 
in our midst to-day. It is work that is, how- 
ever, gradually growing, and every woman in 



BETTER BABIES 235 

the country is beginning to take her share of the 
responsibility, the education, and the training 
which it is now found necessary for her to have 
to enable her to be a successful mother. Na- 
ture has given her the physical qualities for 
motherhood; civilization must help her to win 
the intellectual and spiritual qualities which this 
high estate demands. 



THE WOMAN'S HOME COMPANION 
CAMPAIGN. 

Perhaps no one publication in the world has 
done more for the expectant mother and for 
the new-born infant than "The Woman's Home 
Companion." As a physician, I can not claim 
to be an extensive reader of popular periodicals, 
especially those designed for women, but I must 
commend this particular magazine, and es- 
pecially Mrs. Anna Steese Richardson who edits 
the Better Babies Department. The contests 
for "Better Babies" has absolutely displaced the 
old "Baby Show," where a child was judged 
merely upon its physical beauty, and that in 
turn was but the opinion of certain selected and 
possibly prejudiced judges. 

To-day, Better Baby Contests are really edu- 
cational occasions, where every mother learns 



236 BETTER BABIES 

exactly where and why her baby is defective, or 
why it falls short of being perfect. Regular 
marks are given, and the idea of registering 
babies originated in Denver, Col., in 1913, at 
the National Western Live Stock Exposition. 
It was on that occasion that a representative of 
the Woman's Home Companion discovered that 
women knew much less about caring for their 
babies than men knew about caring for their 
stock. From this time, the campaign for better 
babies may be said to have really begun. It 
has swept the country from end to end, and in 
the rural districts particularly, better baby con- 
tests are held in connection with county and 
state fairs; and with each contest the interest 
grows. Prizes were offered in almost all locali- 
ties by the Woman's Home Companion, and 
while these were eagerly competed for, the real 
value of the movement was not in the money 
awards but in the education given to mothers 
everywhere. During 19 13-14, forty-six states 
held better babies contests at their fairs, and 
457 counties held local contests in addition. 
Many communities are being reached by litera- 
ture from the Woman's Home Companion, the 
main subjects covered being the following: 

"How to Conduct a Better Babies Contest." 

"Suggestions to Physicians." 

"Instructions for Scoring." 



BETTER BABIES 237 

"Hints to Mothers who want Better Babies." 
"What Every Mother Wants to Know About 
Her Baby." 

"Little Helps for Expectant Mothers." 
These pamphlets are sent on request to any 
mother who wishes them, and they are doing in- 
calculable good, especially in outlying districts 
where women are far removed from the cities 
and where not even community life is possible. 

Too much praise can not be given to "The 
Woman's Home Companion" and to every oth- 
er periodical, such as "The Mother's Maga- 
zine," and others of a similar nature, which de- 
vote time, attention, and intelligence to the im- 
proving of our babies. 

A Nation- Wide Better Babies Week. 

So great a hold on the public has the question 
of better babies become, that during this year 
(1916) we are having the first "Better Babies 
Week," which is being observed all over the 
country. Mrs. Anna J. H. Pennybacker, Presi- 
dent of the General Federation of Woman's 
Clubs, has issued a long, comprehensive, and 
enlightening circular letter to ALL American 
club women, urging their co-operation in this 
Better Babies Week. This letter explains in de- 
tail how great a need it is for women every- 
where to know more about their own babies, to 



238 BETTER BABIES 

be able to give them the attention they need, 
and by this giving to reduce the infant mortality 
which is, even with all our efforts, still entirely 
too great. 

In the large cities of the country, physicians 
are addressing club women, Parent-teacher As- 
sociations, Missionary Societies, and organized 
women everywhere, on the subject of the child; 
its requirements, and its demands. 

Mrs. Pennybacker announces, in her letter 
already referred to, that the first week in March 
has been decided upon as being suitable for this 
nation-wide work, and it is inspiring to physi- 
cians, as it must be to mothers, to think that 
thousands, and even tens of thousands, of other 
mothers and other physicians are also working 
together for an improvement in our babies. 

"The baby-saving campaign," says Mrs. 
Pennybacker, "may vary between a simple com- 
munity plan of publicity, with meetings and days 
devoted to the consideration of the baby, and 
an elaborate campaign including other special 
features, such as an exhibit, health conferences, 
outings, etc." 

All plans are GOOD, and should be thor- 
oughly indorsed by every citizen, as well as by 
every humanitarian. Certainly I can not com- 
mend too strongly every effort that tends to 
give our nation really a race of "Better Babies." 



BETTER BABIES 239 

"DONTS FOR MOTHERS: 1 

1. Don't leave the preparation of your baby's 
food to the nurse (unless she be specially train- 
ed) ; DO IT YOURSELF. 

2. Don't try to feed your baby artificially 
without consulting a physician. 

3. Don't give your baby unclean milk from 
an unclean bottle through an unclean nipple. 

4. Don't forget to test your ice box, and to 
keep your milk below 50 degrees F. 

5. Don't let the milk stand in the sun, and 
then blame the milkman if it is sour. 

6. Don't shake your baby up and down after 
nursing. If you are fond of churning get a job 
in a butter factory. 

7. Don't pick your baby up every time it 
cries. Find the cause of the cry and remove it. 

8. Don't rock your baby to sleep. 

9. Don't let a wet diaper remain on the baby. 

10. Don't let the navel band or diaper be too 
tight. 

11. Don't let baby's feet and abdomen get 
cold. 

12. Don't keep baby in a stuffy room. Give 
it fresh, pure air. 

13. Don't slam the door or make a loud noise 
when baby is asleep. 



240 BETTER BABIES 

14. Don't let a strong light shine in the baby's 
eyes. 

15. Don't bathe the baby in front of an open 
grate with a fire in it, unless the fire and grate 
are screened with a fender. 

16. Don't put your baby in the bath without 
testing the water with a bath thermometer. 

17. Don't keep poisons in the house unless 
you keep them under lock and key. 

18. Don't give the baby paregoric or other 
opiates without the advice of your physician. 

19. Don't give your baby a patent medicine 
of ANY kind. If you MUST use them take 
them yourself. 

20. Don't allow your child to become a nui- 
sance to the neighborhood. 

21. Don't give advice to a neighbor about her 
baby; every child is a law unto itself. Inter- 
ference fills the cemeteries. 

22. Don't think, that because your baby is 
fattening on a certain diet, the same diet will 
agree with your neighbor's baby. 

23. Don't think, that because your neighbor's 
baby is FATTER than your baby, you must be- 
gin the stuffing process with your baby. 

24. Don't think you know more than your 
physician; if you haven't confidence in him, get 
another. 



BETTER BABIES 241 

25. Don't advise your physician what to do, 
or suggest a portion of baby's diet; this is his 
business. 

26. Don't expose your child to contagious 
diseases. 

27. Don't get angry with your physician 
when he diagnoses a case of contagious disease, 
and insists that a card be placed on your house 
by the Board of Health. This is a necessary 
protection of the public. 

28. Don't call in a new physician unless you 
have dismissed your first one. 



"HAD I BUT KNOWN." 

In every page of the foregoing I have en- 
deavored to impress young mothers and nurses 
with the importance of recognizing the varied 
symptoms which indicate illness in young chil- 
dren, and to endeavor in every possible way to 
give these symptoms the proper medical atten- 
tion which they deserve. 

Nature, herself, has implanted in the breast 
of every mother a deep desire to protect her 
young, even if by so doing she sacrifice her own 
life. Therefore, I fully believe that American 
and modern mothers need only to be told of 
the need of certain elements of knowledge in 



242 BETTER BABIES 

caring for their children, in order to inspire 
them to acquire this knowledge. It is this point 
that I have endeavored to emphasize through- 
out all of the foregoing. Lack of knowledge 
need not be an excuse for mistakes, as avenues 
for acquiring knowledge are open to all. If 
these avenues are disregarded or ignored, then 
there must inevitably follow the regret, remorse, 
and despair which will assail every mother who 
is separated from her beloved offspring by the 
inexorable hand of Death. 

It is a lamentable fact that ignorance is the 
true cause of our appalling rate of infant mor- 
tality; even when we consider the poverty, the 
filth, and the destitution, in our large cities, and 
the inevitable influence on the death rate which 
this combination creates, we must admit that 
even under the worst social conditions, a moth- 
er's KNOWLEDGE of what was needed 
would, in a great measure, protect her child. 

Therefore, to physicians who know, and to 
those mothers who are willing to learn, must 
be entrusted the sacred obligation of passing 
on this knowledge, until there dawns a day 
when there shall be no single grave stone in 
all the land bearing this inscription in letters 
of stone, or in letters of fire on the mother's 
heart — "Had I but Known!" 






MD I BUT KNOWN' 
MOWER 



' *'>'*^itim& 



THE REAL CAUSE OP INFANT MORTALITY. THE IGNORANT 
MOTHER WHO FAILS TO RECOGNIZE DISEASE MEANS THE 
MOTHER WHO SHALL SUFFER WITH EVERLASTING REGRET. 



BETTER BABIES 243 

A FEW GOOD RECIPES. 

Barley Water: Robinson's or Brooks' 
barley flour, one level tablespoonful. 

Water, one pint. 

A pinch of salt. 

Stir the flour with a little cool water to make 
a thin paste, add the rest of the water, then boil 
for twenty to thirty minutes, and strain through 
a fine strainer, and add enough boiled water to 
make a pint. 

Barley Gruel: Use twice as much barley 
flour, and make in the same way as barley water. 

Albumen- Water : Add the white of one egg 
to a pint of cool boiled water, stir and strain. 
Add a pinch of salt. 

Whey : Take one pint of fresh milk, heat to 
lukewarm 100 degrees F., add two teaspoonfuls 
of Fairchild's Essence of Pepsin, and stir enough 
to mix. Let it stand firmly until curdled, then 
divide the curd with a fork by beating it gently, 
and strain through a piece of sterile muslin. The 
whey is then ready for use. 

Oatmeal Water, Rice Water: Take a 
tablespoonful of either, add one pint of water, 
boil three hours, adding water from time to 
time, to make a pint, and strain. 

Mutton, Veal, or Beef Broth: Take 
one pound of the meat, free from fat, add one 



244 BETTER BABIES 

quart of water, and simmer slowly for three 
hours. Strain through a fine strainer, remove 
all fat, as it cools, add salt to taste. Given 
warm or cold. 

Chicken Broth: Take a portion of a hen 
(never a young chicken) about a pound, cut 
into small pieces, add a quart of water. Sim- 
mer slowly for three hours, strain, and add 
boiled water to make a quart. Strain all the 
fat off, and season with salt. 

Beef Juice: One pound of lean round 
steak, cut thick, a sprinkle of salt on it; broil 
slightly. Cut it in small pieces and squeeze out 
the juice by means of a meat press or lemon 
squeezer. This juice may be given warm, but 
not hot, as it coagulates the albuminous part. 

Protein Milk (Eiweiss Milch) : Heat one 
quart of milk to ioo degrees F., add one table- 
spoon Ess. Pepsin and stir well. Allow to stand 
at same temperature, one-half hour, and strain 
or filter. Force the curd through a strainer at 
least twice, and add one pint of water and one 
pint of buttermilk. 



INDEX 

A 

Abdomen, pressure into 56 

tenderness of 49 

Abortion, from sexual intercourse 37 

Acid, acetic 218 

boric 62 

carbolic 218 

lactic 218, 219 

muriatic 221 

nitric 221 

oxalic 222 

Aconite 222 

Adenoids 160, 190 

symptoms of 191, 192 

Air, cold 112, 113, 114 

cool 112 

fresh no, m, 112, 114 

Airing 72, 73 

Albumen-water 243 

Alcohol 222 

Aconite 222 

Anemia 120 

Antidotes 220, 221, 222, 223 

Artificial feeding of infants 91 

perplexing problems 91 

prevention of 92 

society as a causative factor 92 

B 

Baby, badly fed 26 

bathing 65 

bottle fed 26, 180, 181 

week 65 

Band, abdominal 48 

new navel 45, 48 

adjusting 48 

advantages of 46, 47 

length of time worn 47, 48 

making 48 

price of 48 

old style 48 

dangers from 48, 49, 52 

Bandage Benders 47 

Manns 47 

width of 47 



246 INDEX 

Bassinet 60 

Bath, hot 231 

mustard 229 

thermometer 65 

Bathing, infant 65, 66 

mother 37 

Binder, (see band). 

Bladder . 53, 55 

congenitally small 160 

control of 159 

Blindness, preventable 62 

Blood, examination of 17 

pressure 113 

Books, source of infection 136 

Breast, bulging 17 

caking 25 

care of 23 

pump 23 

Bronchi 113 

Bronchitis 201, 202 

Broth, beef 243 

chicken 244 

mutton - 243 

veal 243 

C 

Cabinet, medicine 223, 224 

list of medicines 225, 226, 227 

Calomel, unwise dosing 126 

Castor oil, promiscuous giving 126 

Chest, development 58 

Child, exhibit 57 

preparations for 43, 44 

study 8 

unborn 9 

welfare 6 

Chloroform, antidote 222 

Cholera infantum, treatment 180 

Chorea 166 

Circumcision 167, 168 

reasons for 169, 170 

"five marks off' 170 

Clinics, dental 214 

medical 214 

Cold in the head 200 

treatment 201 



INDEX 247 

Colic 47, 144 

causes (see band and diaper) 145 

treatment 145 

Complaint, summer 179, 182 

prevention 182, 183, 184, 185 

symptoms 180 

Confinement, choice of room 38 

hurry to be avoided 38 

preparation of bed 42 

preparation of room 38 

Congress of Mothers 233 

Constipation 152 

causes of, (see band and diaper) 153 

treatment 154 

Contagious diseases .... 129, 130, 140, 193, 198, 199 

Contest, "Better Babies" 57, 170, 235, 236 

Cord, dressing 62 

tying 42 

Corset 52 

Coryza, symptoms 200 

treatment 201 

Creosote, antidote 222 

Credes method 62 

Crib 69 

preparation of 70 

Croup, membranous 140, 193, 196, 197 

simple 193, 194 

Crying 71, 72 

Cure, sun 122 

Cystitis 160 

D 

Deformity, prevention of 45 

Development 58, 59, 60, 61 

moral 8 

Diabetis 160 

Diaper 45, 58 

adjusting 49 

advantages of new method So, 51 

how to fold and fasten (see illustrations) • • 50 

disadvantages of old 49. S3, 55 

Diet, after twelfth month 102, 103 

twelfth to fifteenth 104 

fifteenth to eighteenth 105 

eighteenth to twenty-fourth 106 

second to third year 107 



248 INDEX 

Diet — Continued. 

third to sixth 109 

importance of 125, 126 

pregnant woman 32 

wet nurse 90 

Diptheria 140, 193, 197, 198, 214 

membranous 193 

nasal 199 

Diseases, contagious 128, 130, 14, 141, 193, 195, 198, 199 

protection against 128 

Displacement, pelvic 56 

uterine 50 

Do not frighten baby 61 

Don'ts for mothers 239, 240 

Dress reforms 45 

Drill, mirror tooth brush 213 

E 

Exercise, baby 72 

pregnant woman 34, 35 

Exhibit, child welfare 57 

Eyes, care of at birth 62, 63 

washing 62, 63 

solutions 62, 63 

F 

Family washing, a menace 143 

Fathers, "Better" 6 

Feeder Brecks 88 

Feeding, artificial 91, 92, 93 

bottle 10 

correct 13 

improper 13 

time for 15 

Fever 161 

how to take rectal temperatures 163 

scarlet 100, 135, 136, 137, 138 

typhoid 100 

Fissures, in nipples 24 

treatment 25 

Fomentations, hot 231 

Fontanelle 59 

Foods, proprietary 100 

spoiled 233 



INDEX 249 

G 

Good habits versus bad habits 76, 77, 78 

"Good Queen Bess," dress of 45 

"Growing pains" 165, 166, 167 

Gums 171 

lancing 179 

rubbing 179 

H 

Habits, bad 76, 82, 83 

good 76, 77, 78, 79, 80 

"Had I but known" 93, 128, 241, 242 

Hair at birth 59 

Head, circumference 58 

Health, city board 129 

State 129 

Heliotherapy 121 

Hip 56 

History of cases important 123 

Hospital for contagious diseases 144 

I 

Incontinence of urine 159, 160 

treatment 160 

Indian papoose 54 

woman 54 

health of 54 

Infant, artificial feeding of 91, 92 

bathing 65 

care of 88, 89 

drying 65 

dusting powder 65 

premature 87, 88, 89 

Intestinal disorders 51 

stasis 51 

Iodine, antidote 222 

J 

Juice, beef 244 

orange 191 

K 

Kissing, indiscriminate 141 



250 INDEX 



Labor, anesthetic 21 

lacerations 20 

post partum hemorrhage 20 

tedious 20 

Lactation 18 

nervous element 19 

Letters, source of infection 136 

Life, plant 116 

city 117 

Light 118 

treatment 119 

M 

Malt soup 100 

Massage 156 

Mastitis 24, 25 

Medicine cabinet 223 

how to make 223 

poisons in 223 

selection of 224 

unique 224, 225 

Milk, certified 97 

advantages 98 

chemical examination 19 

commission 97, 98 

condensed 100 

cows 93, 94, 95, 96, 97, 98 

care in handling 94, 95, 96 

difference between and mothers • 93, 94, 95, 96 

diseases caused by impure 100 

mothers 11, 13, 14, 15, 16, 17, 18, 19, 21 

effect of social excitement 12 

negroes 14 

protein, (Eiweiss) 244 

secretions 16 

Mortality, infant 6 

Mother, protection of 9 

surroundings 20 

universal 9 

Mothers' Congress 233 

ignorance 131 

list for 44 



INDEX 251 

Mustard 228 

bath 229 

pack 230 

plaster 228, 229 

N 

National Congress of Mothers 7, 233 

wonderful work 233, 234 

Nerves, high tension 16 

New navel band (see band) 45 

Nipples, care of 23, 99 

sore 25 

treatment 25 

Neurasthenia 29, 121 

Nurse, obstetrical 21 

duties 21 

selection 21 

wet 89 

diet 90 

selection 89, 90 

O 

Oil, castor 126 

olive 24 

Russian 155 

Opiate 184 

Opium, antidote 222 

Orange juice 184 

P 

Pains, growing 165, 166 

Papoose 54 

Pasteurization 99 

Pelvis, bones of 52 

injury to S3, 56 

texture 52, 53 

Pharyngitis, naso 113 

Phimosis, congenital 168 

Physicians, registered 63 

Pins, safety 50 

Playgrounds 142, 143 

Pneumonia 203 

Poisons 220, 221, 222, 223 

Pregnancy, bathing 37 

clothing 36 

diet 38 



252 INDEX 

Pregnancy — Continued. 

exercise 34 

high nervous tension 16 

protecting mother 9 

sexual intercourse 37 

Protection against contagious diseases 128 

Punishment 81 

Pyuria 158 

R 

Race welfare 6 

Recipes 243, 244 

Refrigerators 231 

care of 233 

selection 232 

proper temperature 232 

Rickets 13, 185, 186 

causes 187 

symptoms 187 

treatment 188 

Rheumatism, (see growing pains) 165, 166 

Russell Sage Foundation 10 

S 

Scarlet fever 135 

care of room 137 

causes 135, 136 

disinfection 139 

dreaded dangers 135, 138 

duty of health department 138, 139 

new theory 139 

prevention 138 

sunshine 138 

School, public 130 

room 131 

Sunday 131 

Scurvy 13, 189 

causes 189 

treatment 190 

Septic sore throat 100 

Sexual intercourse 37 

Sigmoid flexure 51, 154 

Silver nitrate, solution 62 

Skin affections 121 

care of 66 

powder 67 

Sleep 68, 69, 70 



INDEX 253 

Smallpox 132, 133 

Society, American Pediatric 100 

Soup 125 

malt 100 

Stasis, intestinal 51 

Sterilization of milk 99 

Stomach, babies 179 

capacity 146 

shape 146 

Stools 128, 152, 183 

Strychnine, antidote 222 

Summer complaint 179 

causes 179, 180 

death rate 179 

prevention 182 

teething, (see teething) 180 

treatment 183, 184, 185 

Sunlight 114, 115, n6, 118, 120 

treatment 121, 122 

Sunshine no, 115, 142, 143 

St. Vitus Dance, (see chorea) 166 

T 

Tea 125 

Teaspoons 227 

Teachers 131 

"Teddy Bears" 136 

Teeth 125 

brushing 211, 214 

care 211 

dental examination 213 

effects of sweets 215, 216, 217, 218, 219 

milk 84, 212 

permanent 84, 85 

Teething 171, 180 

process 172, 173 

symptoms .... 171, 172, 175, 176, 177, 178, 179 

Temperature, correct way 162, 163, 164 

normal 161 

Thermometer, bath 65 

clinical 161 

Tonsillitis 197, 198 

Tooth brush 215 

mirror drill 213 

powder 215 

Toys, source of infection 136 



254 INDEX 

Trachea 113 

Tuberculosis 100, 141, 142 

indiscriminate kissing 141 

protection against 141 

sanitariums 142 

U 

Urine 157 

incontinence 157, 158 

jaundice 157 

normal 157 

Pus 158 

reaction 158 

Uterus 53, 55, 56 

position 55 

V 

Vaccination 132 

ages 134 

precautions 133, 134 

Vomiting, a symptom 146 

causes 146, 147, 148 

importance of diagnosis 148, 149 

W 

Washing, family 143 

Water, albumen 243 

barley 243 

oatmeal 243 

Weaning 85 

causes 86, 87 

Weighing the baby 74 

Welfare, child 6 

race 6 

Whey 243 

Whooping cough 203 

campaign 205 

diagnosis 205 

symptoms 204 

treatment 208, 209, 210 

Wife, choice 12 

Wine, blackberry 127 

Woman, pregnant 17 

Woman's Home Companion 7, 235, 236, 237 

Women, dress 45, 46 

reforms 45 

Wonderful Work of the Mothers' Congress .... 233 

Worms 160 



